Musosal tumour necrosis factor α in diverticular disease of the colon is overexpressed with disease severity

Tursi, Antonio; Elisei, Walter; Brandimarte, Giovanni; Giorgetti, Gian Marco; Inchingolo, Cosimo Damiano; Nenna, Rosanna; Picchio, Marcello; Giorgio, Floriana; Ierardi, Enzo

doi:10.1111/j.1463-1318.2012.02926.x

Cited by 50 publications

(38 citation statements)

References 41 publications

(64 reference statements)

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“…Surprisingly, TNF-α was not positively associated with the presence (p = 0.3) of diverticulosis in our study. Several studies by Tursi et al report that TNF-α increased with the severity of diverticular disease [13], [14]. However, our subjects were asymptomatic and undergoing preventive screening colonoscopy, so the severity of diverticular disease and the TNF-α concentrations among the participants were lower than those reported in the Tursi studies.…”

Section: Discussioncontrasting

confidence: 61%

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Cross-Sectional Analysis of Obesity and Serum Analytes in Males Identifies sRAGE as a Novel Biomarker Inversely Associated with Diverticulosis

et al. 2014

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Diverticulosis can lead to diverticulitis, a colon condition involving inflammation and other complications. Diverticulosis can result from biological, behavioral, or genetic causes. However, the etiology of diverticulosis is unknown. Although diet is associated with diverticulosis, recent studies suggest other factors influence risk. We sought to identify anthropometric or serum markers that were associated with the presence of diverticulosis. To determine these associations, 126 asymptomatic men (48–65 yr) were recruited at the time of preventative screening colonoscopy. Anthropometric measures were taken, and blood was collected for serum protein analysis. Data were analyzed by logistic regression and factor analysis. Obese individuals (BMI >30) were 7.8 (CI: 2.3–26.3) times more likely than normal weight (BMI <25) individuals to have diverticulosis. The relationship was similar for waist circumference. Individuals with a waist circumference >45 inches were 8.1 (CI: 2.8–23.8) times more likely to have diverticulosis than those with a waist circumference <38 inches. Leptin was also positively associated with diverticulosis (OR = 5.5, CI: 2.0–14.7). Both low molecular weight adiponectin (LMW, OR = 0.50; CI: 0.3–0.8) and the soluble receptor for advanced glycation end products (sRAGE, OR = 0.4, CI: 0.3–0.7) were inversely related to the presence of diverticulosis. sRAGE levels were not correlated with leptin or C-peptide concentrations. The pattern of high BMI, waist circumference, leptin and C-peptide increased the odds of diverticulosis while the pattern of high levels of sRAGE and LMW adiponectin decreased the odds of diverticulosis. Associations between diverticulosis and anthropometric or serum markers may elucidate the origins of diverticulosis and may enable physicians to identify individuals at risk for diverticulitis.

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Section: Discussioncontrasting

confidence: 61%

“…Tumor necrosis factor (TNF)-α is the only inflammatory molecule associated with diverticulosis and diverticular disease to date [13], [14]. The relationships between diverticulosis and factors such as other serum cytokines, serum adipokines, or serum markers of insulinemia are poorly characterized.…”

Section: Introductionmentioning

confidence: 99%

Cross-Sectional Analysis of Obesity and Serum Analytes in Males Identifies sRAGE as a Novel Biomarker Inversely Associated with Diverticulosis

et al. 2014

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“…This microscopic inflammation, ranging from increased chronic lymphocytic infiltration to active neutrophilic infiltrate, seems to be linked to the severity of the disease [27]; ii) DD shows an enhanced expression of pro-inflammatory cytokines as TNF-a [28,29]. Moreover, the over-expression of this cytokine decreases parallel to response to therapy [30,31]; iii) Obesity is a risk factor for diverticulitis recurrence, due to the pro-inflammatory effect of adipokines and chemokines [32]; iv) Both persisting endoscopic and histological inflammation have recently been identified as significant risk factors for diverticulitis recurrence [33]; v) up to 20% of patients complain of persistent abdominal pain after surgical treatment of diverticulitis, and quality of life of patients is not significantly improved after surgery [34].…”

Section: Inflammationmentioning

confidence: 99%

New medical strategies for the management of acute diverticulitis

Tursi

2015

Expert Review of Gastroenterology & Hepatology

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Acute diverticulitis, defined as acute inflammation of a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in the medical treatments offered to patients in recent years. Factors predisposing individuals to the development of acute diverticulitis include obesity, smoking, lack of physical activity and medication use, such as NSAIDs. Although widely used, there is limited evidence on the efficacy of individual antibiotic regimens and antibiotic treatment may not be required in all patients. Mesalazine seems to be the only effective treatment for the primary prevention of acute diverticulitis. Finally, evidence of effective measures for the prevention of recurrence is lacking. Furthermore, high-quality randomized controlled trials are required for medical treatments in patients with acute diverticulitis, if management is to be evidence based.

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“…Antibiotics Our understanding of the pathophysiology of diverticulitis has recently expanded from a primarily infectious entity to an appreciation of the inflammatory nature of the condition, with increased expression of proinflammatory mediators [17,18]. As a result, and with an increasing awareness of judicious antibiotic use, some clinicians are challenging established doctrines of antimicrobial therapy in acute diverticulitis.…”

Section: Medical Managementmentioning

confidence: 99%

Current Controversies in the Management of Diverticulitis: A Review

Nally

Kavanagh

2018

Dig Surg

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Background: Symptomatic diverticular disease is challenging for patients, clinicians and health services. The prevalence increases with age and BMI and as such, the burden of this disease is set to increase with higher rates of acute presentations already documented. The natural history of recurrent episodes, complications and symptom progression is not fully understood. Furthermore, medical and surgical management strategies are under constant appraisal, debate and evolution. Methods: A review of the contemporary literature was performed to examine the emerging trend towards conservative treatment. Results: Routine use of in-patient, intravenous antibiotics may not be required and outpatient management is possible for certain patients. Universal colonoscopy examination after uncomplicated acute diverticulitis is controversial but is mandatory after complicated episodes. Recent, high-profile, clinical trials suggest that less aggressive surgical management of both acute and chronic presentations may be feasible in some cases. Conclusions: Diverticulitis is a common yet challenging topic that demands clinicians to provide an individualised yet evidence-based approach.

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Musosal tumour necrosis factor α in diverticular disease of the colon is overexpressed with disease severity

Abstract: TNF-α expression in DD seems to be related to the severity of the disease. In particular, it appears to be overexpressed in DD with inflammation (AUD and SUDD) compared with DD without (AD).

Cited by 50 publications

References 41 publications

Cross-Sectional Analysis of Obesity and Serum Analytes in Males Identifies sRAGE as a Novel Biomarker Inversely Associated with Diverticulosis

Cross-Sectional Analysis of Obesity and Serum Analytes in Males Identifies sRAGE as a Novel Biomarker Inversely Associated with Diverticulosis

New medical strategies for the management of acute diverticulitis

Current Controversies in the Management of Diverticulitis: A Review

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