Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review

Mihai, Ioana Ruxandra; Burlui, Alexandra Maria; Rezus, Ioana Irina; Mihai, Cătălina; Macovei, Luana Andreea; Cardoneanu, Anca; Gavrilescu, Otilia; Dranga, Mihaela; Rezus, Elena

doi:10.3390/life13081779

Cited by 4 publications

(2 citation statements)

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“…Inflammatory bowel diseases (IBDs) such as Crohn's disease (CD) and ulcerative colitis are the result of an over-reactive immune system that targets the gastrointestinal tissue, resulting in inflammation and subsequent abdominal pain, bleeding, weight loss, and malnutrition [53][54][55][56][57]. Several studies have shown that LFA-1 plays a crucial role in the development of the disease.…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Therapeutic Applications of Aggregatibacter actinomycetemcomitans Leukotoxin

Kachlany,

Vega

2024

Pathogens

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Aggregatibacter actinomycetemcomitans is a Gram-negative oral bacterium that has been primarily studied for its role in causing periodontal disease. The bacterium has also been implicated in several systemic diseases such as endocarditis and soft tissue abscesses. Leukotoxin (LtxA) is perhaps the best studied protein virulence factor from A. actinomycetemcomitans. The protein can rapidly destroy white blood cells (WBCs), helping the bacterium to subvert the host immune system. The functional receptor for LtxA is lymphocyte function associated antigen-1 (LFA-1), which is expressed exclusively on the surfaces of WBCs. Bacterial expression and secretion of the protein are highly regulated and controlled by a number of genetic and environmental factors. The mechanism of LtxA action on WBCs varies depending on the type of cell that is being killed, and the protein has been shown to activate numerous cell death pathways in susceptible cells. In addition to serving as an important virulence factor for the bacterium, because of its exquisite specificity and rapid activity, LtxA is also being investigated as a therapeutic agent that may be used to treat diseases such as hematological malignancies and autoimmune/inflammatory diseases. It is our hope that this review will inspire an increased intensity of research related to LtxA and its effect on Aggressive Periodontitis, the disease that led to its initial discovery.

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Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Therapeutic Applications of Aggregatibacter actinomycetemcomitans Leukotoxin

Kachlany,

Vega

2024

Pathogens

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“…Moreover, IBD can manifest as a paradoxical reaction to TNFi treatment. 8 Anti-TNF agent therapy may potentially increase the risk of IBD. 9 Tofacitinib has been employed in the treatment of axSpA and IBD.…”

mentioning

confidence: 99%

Upadacitinib in a patient with concurrent refractory axial Spondyloarthritis and inflammatory bowel disease: A case report

Li,

Pan,

Zheng

et al. 2024

Int J of Rheum Dis

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Axial spondyloarthritis (axSpA) is a chronic inflammatory arthritis that predominantly affects the spine, leading to stiffness, pain, and reduced mobility. 1 This condition is closely linked to another inflammatory disorder, namely inflammatory bowel disease (IBD). 2The incidence and prevalence of IBD are elevated in axSpA compared with the general population. The estimated overall incidence of IBD in patients with axSpA ranges from 5% to 10%. 3 IBD encompasses conditions such as Crohn's disease (CD) and ulcerative colitis (UC), both of which involve chronic inflammation of the gastrointestinal tract. The coexistence of axSpA and IBD in some individuals is known as spondyloarthritis with IBD, highlighting the intricate interplay between these inflammatory conditions. 4 Several diseasemodifying antirheumatic drugs (DMARDs), such as sulfasalazine, as well as biologic therapies, including TNF inhibitors (TNFi) and Janus kinase inhibitors (JAKi), have been utilized in the treatment of patients concurrently experiencing axSpA and IBD. 5 However, treating axSpA alongside IBD can be challenging. Here, we report a case in which Upadacitinib successfully treated a patient with concurrent refractory axSpA and IBD.

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