Inflammatory bowel disease in India - Past, present and future

Ray, Gautam

doi:10.3748/wjg.v22.i36.8123

Cited by 47 publications

(35 citation statements)

References 93 publications

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“…4,14 This difference in distribution of UC and CD may be related to the differences in genetic heterogeneity, hygiene, and diet between the people of North and South India. 15,16 In our study as well, we found more UC cases than CD, and the proportion remained the same despite an increase in incidence in overall IBD. A recent study on 95 605 incident cases of CD and 112 004 incident cases of UC showed that the age of IBD onset varies with gender.…”

Section: Discussionsupporting

confidence: 77%

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

et al. 2020

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Background/Aim: Inflammatory bowel disease (IBD) is said to be rare in Asian children, and there is scarce information from India. We therefore analyzed our experience of pediatric IBD. Methods: Prospectively maintained data of 105 consecutive children [median age 12 (IQR:7-14) years, 71 males] with IBD from July 2001 through June 2016 were retrospectively analyzed. Their detailed clinical features, endoscopic appearance, histopathology, and treatment outcomes were recorded. For Crohn's disease (CD), disease phenotype and disease location were assessed as per Paris classification. Results: Disease spectrum includes ulcerative colitis (UC), 55 (52%); CD, 43 (41%); and IBD-unclassified, 7 (7%). There was a significant increase in the number of cases in the last 5 years compared to the previous 10 years (63 vs. 42, r 2 = 0.96). Most UC cases (75%) had extensive/pancolitis, 74% of CD had colonic/ileocolonic disease, and 65% had inflammatory phenotype. Fever, growth failure, pain in abdomen, and need for surgery were significantly more frequent in CD than in UC (P < 0.0001). Over a median follow up of 19 (IQR: 7-48) months, remission was achieved in 48 of 51 (94%) UC patients and in 24 of 34 (70.6%) CD patients; an immunomodulator was required to maintain remission in 67% of UC cases. In CD, there was a significant reduction in the use of empirical antitubercular therapy (76%, P = 0.008) with time, and disease progressed in three. Conclusions: IBD is not uncommon, and the incidence seems to be increasing among Indian children. UC is more common than CD and is more often an extensive disease. CD is mainly an inflammatory phenotype. The majority of children with IBD required an immunomodulator to maintain remission.

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Section: Discussionsupporting

confidence: 77%

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

et al. 2020

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“…UC is the most predominant type of IBD with a prevalence of 7.6 to 246.0 cases per 100000 per year, followed by CD which has a prevalence of 3.6 to 214.0 cases per 100000 per year[ 3 ]. The worldwide distribution of IBD is skewed towards being more prominent in North America and Europe, although in the past two decades its prevalence has risen in developing countries like China and India[ 4 , 5 ]. This change in trends has paralleled with changes in dietary habits like inclusion of processed foods, increased intake of sugars and fats, overutilization of antibiotics and an overall improvement in hygiene.…”

Section: Introductionmentioning

confidence: 99%

Secondary causes of inflammatory bowel diseases

Ghouri¹,

Tahan²,

Shen³

2020

WJG

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Inflammatory bowel diseases (IBD), conventionally consist of Crohn’s disease (CD) and ulcerative colitis. They occur in individuals with high risk genotype for the disease in the setting of appropriate environmental factors. The pathogenesis of IBD involves a dysregulated autoimmune response to gut dysbiosis, which in turn is triggered due to exposure to various inciting environmental factors. But there is no clearly defined etiology of IBD and this type of disease is termed as “idiopathic IBD”, “classic IBD”, or “primary IBD”. We reviewed the current medical literature and found that certain etiological factors may be responsible for the development of IBD or IBD-like conditions, and we consider this form of de novo IBD as “secondary IBD”. Currently known factors that are potentially responsible for giving rise to secondary IBD are medications; bowel altering surgeries and transplantation of organs, stem cells or fecal microbiome. Medications associated with the development of secondary IBD include; immunomodulators, anti-tumor necrosis factor alpha agents, anti-interleukin agents, interferons, immune stimulating agents and checkpoint inhibitors. Colectomy can in some cases give rise to de novo CD, pouchitis of the ileal pouch, or postcolectomy enteritis syndrome. After solid organ transplantation or hematopoietic stem cell transplantation, the recipient may develop de novo IBD or IBD flare. Fecal microbiota transplantation has been widely used to treat patients suffering from recurrent Clostridium difficile infection but can also causes IBD flares.

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“…Ulcerative colitis (UC) and Crohn’s disease (CD) are two sub-types of IBD differing in few histological and pathological features. IBD occurrence in India tends to follow a north-south divide where UC and CD is predominant in north and south India respectively 1 . Incidence and prevalence rates of UC reported in India are the highest in Asia 2 .…”

Section: Introductionmentioning

confidence: 99%

Altered expression of Tumor Necrosis Factor Alpha -Induced Protein 3 correlates with disease severity in Ulcerative Colitis

Majumdar

Ahuja

Paul

2017

Sci Rep

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Ulcerative colitis (UC), an inflammatory disorder of the colon arises from dysregulated immune response towards gut microbes. Transcription factor NFκB is a major regulatory component influencing mucosal inflammation. We evaluated expression of Tumor Necrosis Factor Alpha Induced Protein3 (TNFAIP3), the inhibitor of NFκB activation and its associated partners ITCH, RNF11 and Tax1BP1 in inflamed mucosa of UC patients. We found highly significant up-regulated mRNA expression of TNFAIP3 that negatively correlated with disease activity in UC. mRNA levels of ITCH, RNF11 and Tax1BP1 were significantly down-regulated. Significant positive correlation with disease activity was noted for Tax1BP1. All four genes showed significant down-regulation at protein level. mRNA levels of inducers of TNFAIP3 expression, NFκB p65 subunit and MAST3 was determined. There was significant increase in p65 mRNA expression and down-regulated MAST3 expression. This suggested that increase in NFκB expression regulates TNFAIP3 levels. Deficiency of TNFAIP3 expression resulted in significant up-regulation of NFκB p65 sub-unit as well as its downstream genes such as iNOS, an inflammatory marker, inhibitors of apoptosis like cIAP2 and XIAP and mediators of anti-apoptotic signals TRAF1 and TRAF2. Taken together, decreased expression of TNFAIP3 and its partners contribute to inflammation and up-regulation of apoptosis inhibitors that may create microenvironment for colorectal cancer.

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Inflammatory bowel disease in India - Past, present and future

Cited by 47 publications

References 93 publications

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

Secondary causes of inflammatory bowel diseases

Altered expression of Tumor Necrosis Factor Alpha -Induced Protein 3 correlates with disease severity in Ulcerative Colitis

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