Mesenteric Blood Flow Is Related to Disease Activity and Risk of Relapse in Crohn's Disease: A Prospective Follow-Up Study

Ludwig, D.; Wiener, S; Brüning, A; Schwarting, Karsten; Jantschek, G.; Stange, Eduard F.

doi:10.1111/j.1572-0241.1999.01442.x

Cited by 73 publications

(17 citation statements)

References 40 publications

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“…On the other hand, assessment using colour Doppler flow of the superior mesenteric artery has shown its usefulness in monitoring the response to treatments with corticosteroids [16] or Azathioprine [17]. However, this measurement is technically difficult and takes a long time to execute, having a 60-70% failure rate and a high level of intra and interobserver variability; it is therefore not used on a regular basis [18].…”

Section: Discussionmentioning

confidence: 98%

Abdominal Sonographic Changes After Antibody to Tumor Necrosis Factor (Anti-TNF) Alpha Therapy in Crohn’s Disease

et al. 2009

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Prospective study carried out on 24 consecutive patients with Crohn's Disease, using sonography to assess changes caused by biological therapy and its relationship with the clinical-biological response. The Crohn's Disease Activity Index, the plasma concentration of C-reactive protein and abdominal sonograms (to assess the thickness and Doppler flow grade of the bowel wall and to detect the presence of any complications) were carried out one week prior to the induction treatment and two weeks after. The biological therapy induced remission or a partial response in 46% and 25% of the patients, respectively. It also caused a significant reduction in the thickness of the bowel wall (P = 0.005) and Doppler flow (P = 0.02), leading to the disappearance of complications in 50% of the patients. Sonographic changes were significantly more marked in patients who achieved some type of clinical-biological response, in such a way that sonograms were improved in 65% (P = 0.001) and complications disappeared in 100% of patients (P = 0.005) compared to those patients who did not respond to treatment. However, sonographic normality was only achieved in five out of 17 (29%) reactive patients (P = 0.27). This fact may support the use of sonography as a technique for optimizing the biological treatment of Crohn's Disease.

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Section: Discussionmentioning

confidence: 98%

Abdominal Sonographic Changes After Antibody to Tumor Necrosis Factor (Anti-TNF) Alpha Therapy in Crohn’s Disease

et al. 2009

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“…The effect was greatly affected by the content of the ingested food, such that a richer energy content produced a greater peak 34) , and either protein or fat intake delayed the peak but increased its value 32,33) . No increase was observed in the IMA after food intake 35) .…”

Section: Effect Of Food Ingestion On the Gastrointestinal Tract At Rementioning

confidence: 78%

Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation

Hayashi

Yamaoka-Endo

Someya

et al. 2012

JPFSM

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In response to increased vascular conductance associated with vasodilation in exercising muscles, many non-exercising organs suppress their blood flow by vasoconstriction, thus helping to maintain blood pressure. This vasoconstriction in non-exercising organs contributes to ensuring a favorable distribution of the blood flow. However, a consequent excessive decrease of blood flow in non-exercising organs should be avoided so that they can maintain appropriate functioning during and/or after exercise. There is now evidence of a decrease in splanchnic blood flow with vasoconstriction during dynamic exercise, which indirectly contributes to an increase in flow in exercising muscles. Hypoperfusion in the splanchnic area, induced by such vasoconstriction, may result in gastrointestinal symptoms. On the other hand, such vasoconstriction is suppressed when exercise is performed after food intake, which may be associated with the maintenance of digestive and absorptive functions in the gastrointestinal tract. In contrast to organs that decrease their blood flow, the choroidal flow, which forms part of the ocular blood flow, increases with exercise intensity, but without vasodilation. The relevance of this phenomenon to visual function and the nature of ocular circulation remain unclear. Competition in blood flow between exercising muscles and non-exercising organs should be examined from the viewpoint of the functions of non-exercising organs and exercising condition, such as the postprandial condition.

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“…An increase flow has been related to disease activity in CD relative to normal bowel suggesting that vascular abnormalities with a compensatory increase in blood flow may have a functional role in this disease. (87,88) It is of note that astrocytes in the central nervous system have been implicated in the regulation of local blood flow. (89,90) We speculate that enteric glial cells share this ability with astrocytes and thus may directly influence the gut microvasculature.…”

Section: Mechanisms Of Necrotizing Enterocolitismentioning

confidence: 99%

Enteric glial cells. An upstream target for induction of necrotizing enterocolitis and Crohn's disease?

Bush

2002

BioEssays

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As a direct consequence of the sophisticated arrangement of its intrinsic neurons, the gastrointestinal tract is unique among peripheral organs, in its ability to mediate its own reflexes. Neurons of the enteric nervous system are intimately associated with enteric glial cells. These supporting cells do not resemble Schwann cells, the glial cell found in all other parts of the peripheral nervous system, but share many similarities with astrocytes of the central nervous system. Ablation of enteric glial cells in adult transgenic mice has demonstrated that these cells are essential to maintain the integrity of the small intestine. Acute loss of enteric glial cells induces massive pathological changes with similarities to necrotizing enterocolitis (NEC) and early Crohn's disease. These human conditions share some mechanistic similarities. Identification of enteric glial cell dysfunction/loss as sufficient to induce necrotic/inflammatory bowel disease may be important to understand the pathogenesis of both NEC and Crohn's disease.

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Mesenteric Blood Flow Is Related to Disease Activity and Risk of Relapse in Crohn's Disease: A Prospective Follow-Up Study

Abstract: Postprandial flow measurements in the superior mesenteric artery are closely related to clinical but not endoscopic disease activity in patients with Crohn's disease. The repeated measurement of the postprandial pulsatility index allows estimation of the risk of recurrence.

Cited by 73 publications

References 40 publications

Abdominal Sonographic Changes After Antibody to Tumor Necrosis Factor (Anti-TNF) Alpha Therapy in Crohn’s Disease

Abdominal Sonographic Changes After Antibody to Tumor Necrosis Factor (Anti-TNF) Alpha Therapy in Crohn’s Disease

Blood flow in non-muscle tissues and organs during exercise: Nature of splanchnic and ocular circulation

Enteric glial cells. An upstream target for induction of necrotizing enterocolitis and Crohn's disease?

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