Immunomodulatory Effect of Vancomycin on Treg in Pediatric Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Abarbanel, David N.; Seki, Shinsuke; Davies, Yinka; Marlen, Natalie A.; Benavides, Joseph A.; Cox, Kathleen M.; Nadeau, Kari; Cox, Kenneth L.

doi:10.1007/s10875-012-9801-1

Cited by 97 publications

(88 citation statements)

References 33 publications

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“…decrease) in enterohepatic circulation of profibroinflammatory microbial metabolites, or (3) non-antimicrobial effects (e.g. anti-inflammatory properties [70]).determining which antibiotic (or combination thereof) is most clinically effective and (1) how it should be dosed in order to provide durable benefits while minimizing risks such as antibiotic resistance and other adverse effects and (2) what the predictors (e.g. IBD status, stage, immunogenetic features) of a therapeutic response to antibiotics may be.…”

Section: Discussionmentioning

confidence: 99%

Primary sclerosing cholangitis and the microbiota: current knowledge and perspectives on etiopathogenesis and emerging therapies

Tabibian

O’Hara

Lindor

2014

Scandinavian Journal of Gastroenterology

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Primary sclerosing cholangitis (PSC) is a chronic, fibroinflammatory, cholestatic liver disease of unknown etiopathogenesis. PSC generally progresses to liver cirrhosis, is a major risk factor for hepatobiliary and colonic neoplasia, and confers a median survival to death or liver transplantation of only 12 years. Although it is well recognized that approximately 75% of patients with PSC also have inflammatory bowel disease (IBD), the significance of this association remains elusive. Accumulating evidence now suggests a potentially important role for the intestinal microbiota, and enterohepatic circulation of molecules derived there from, as a putative mechanistic link between PSC and IBD and a central pathobiological driver of PSC. In this concise review, we provide a summary of and perspectives regarding the relevant basic, translational, and clinical data, which, taken together, encourage further investigation of the role of the microbiota and microbial metabolites in the etiopathogenesis of PSC and as a potential target for novel pharmacotherapies.

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Section: Discussionmentioning

confidence: 99%

Primary sclerosing cholangitis and the microbiota: current knowledge and perspectives on etiopathogenesis and emerging therapies

Tabibian

O’Hara

Lindor

2014

Scandinavian Journal of Gastroenterology

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“…One underpowered, double-blind, controlled study of oral vancomycin as add-on treatment to intravenous steroids in 33 adult patients with acute severe colitis reported a lower numerical rate of short-term colectomy in the vancomycin arm (11%) vs. placebo (47%; p = 0.057) [8]. In a few case series and one small controlled study, vancomycin has been found to improve PSC [4,5,8,9,10]. Two of these studies were in children and reported that the IBD-related symptoms also improved in all patients; those patients who underwent repeat colonoscopy showed endoscopic resolution or improvement [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…While children with PSC treated with vancomycin have been reported to incidentally also show improvement in concurrent IBD [4,5], vancomycin has never been studied as exclusive therapy for VEO-IBD. Gentamicin is a nonabsorbable agent with efficacy against Escherichia coli - an abundant pathogen in the mucosa and intracellular compartment in IBD, which may have a potential pathogenetic role in IBD [6].…”

Section: Introductionmentioning

confidence: 99%

Oral Vancomycin and Gentamicin for Treatment of Very Early Onset Inflammatory Bowel Disease

Lev-Tzion

Ledder²,

Shteyer³

et al. 2017

Digestion

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Background: The pathogenesis of inflammatory bowel disease (IBD) is complex and involves the contribution of genetic and environmental factors. Many patients with very early onset IBD are difficult to treat. The current antibiotic medication that targets gram-negative and anaerobic bacteria provides only moderate efficacy in subsets of patients with IBD. Methods: We report a case series of 5 children with a mean age of 1.6 years (range 6 months to 2.7 years) during IBD onset, who were previously refractory to standard treatments and who received oral vancomycin with or without gentamicin. Results: Four out of 5 children demonstrated substantial therapeutic effect, and the effect was sustained in 3 children over a follow-up period of 12-33 months. Conclusion: Our findings are consistent with model systems and suggest that randomized trials are required to establish whether a change in therapeutic paradigm, that is, targeting gram-positive bacteria with nonabsorbable antibiotics, may have therapeutic benefits.

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“…Even in those subjects with concurrent IBD, screening of CRC is controversial, since it s rarely seen before 16 years of age (75,113,114) . Up to now, there is controversy on the employment of UDCA in adults with PSC and there are no controlled data on their use in children (75,(113)(114)(115)117,119) Antibiotics, such as oral vancomycin are still under investigation (114)(115)(116)120) . Dominant strictures are less common in children with PSC, but are also amenable to treatment, as highlight previously (114,115) .…”

Section: Diagnositc and Therapeutic Implications For Psc In Childrenmentioning

confidence: 99%

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

Bittencourt

Cançado

Couto

et al. 2015

Arq. Gastroenterol.

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-In order to draw evidence-based recommendations concerning the management of autoimmune diseases of the liver, the Brazilian Society of Hepatology has sponsored a single-topic meeting in October 18th, 2014 at São Paulo. An organizing committee comprised of seven investigators was previously elected by the Governing Board to organize the scientific agenda as well as to select twenty panelists to make a systematic review of the literature and to present topics related to the diagnosis and treatment of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis and their overlap syndromes. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

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Immunomodulatory Effect of Vancomycin on Treg in Pediatric Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

Cited by 97 publications

References 33 publications

Primary sclerosing cholangitis and the microbiota: current knowledge and perspectives on etiopathogenesis and emerging therapies

Primary sclerosing cholangitis and the microbiota: current knowledge and perspectives on etiopathogenesis and emerging therapies

Oral Vancomycin and Gentamicin for Treatment of Very Early Onset Inflammatory Bowel Disease

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

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