Non-smoking: a feature of ulcerative colitis.

Harries, Anthony; Baird, Andrew D.; Rhodes, J.

doi:10.1136/bmj.284.6317.706

Cited by 307 publications

(116 citation statements)

References 3 publications

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“…[1][2][3][4] Paradoxically, UC appears to be predominantly a disease of ex-smokers and nonsmokers. 2, First noted by Samuelsson in 1976 25 and confirmed by Harries, Baird and Rhodes in 1982, 26 it was observed that there was a distinct lack of current smokers in a cohort of UC patients, compared with that of a group of matched control subjects. Since then, numerous studies of the relationship between smoking and UC have confirmed this observation and demonstrated that smoking not only appears to protect against the development of UC, but in fact ameliorates the clinical course of the disease.…”

Section: Introductionmentioning

confidence: 99%

Review article: ulcerative colitis, smoking and nicotine therapy

Lunney

Leong

2012

Aliment Pharmacol Ther

119

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SummaryBackgroundSmoking is the best‐characterised environmental association of ulcerative colitis (UC). Smoking has been observed to exert protective effects on both the development and progression of UC.AimsTo examine the association between UC and smoking, possible pathogenic mechanisms and the potential of nicotine as a therapeutic agent in the treatment of UC.MethodsA literature search was conducted through MEDLINE, using the MeSH search terms ‘ulcerative colitis’ and ‘smoking’ or ‘nicotine’. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.ResultsUlcerative colitis is less prevalent in smokers. Current smokers with a prior diagnosis of UC are more likely to exhibit milder disease than ex‐smokers and nonsmokers. There is conflicting evidence for smokers having reduced rates of hospitalisation, colectomy and need for oral corticosteroids and immunosuppressants to manage their disease. Multiple potential active mediators in smoke may be responsible for these clinical effects, including nicotine and carbon monoxide, but the precise mechanism remains unknown. Nicotine has demonstrated variable efficacy in the induction of remission in UC when compared to placebo and conventional medicines. Despite this, the high frequency of adverse events limits its clinical significance.ConclusionsNicotine's application as a therapeutic treatment in ulcerative colitis is limited. Presently, it may be an option considered only in selected cases of acute ulcerative colitis refractory to conventional treatment options. This review also questions whether nicotine is the active component of smoking that modifies risk and inflammation in ulcerative colitis.

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Section: Introductionmentioning

confidence: 99%

Review article: ulcerative colitis, smoking and nicotine therapy

Lunney

Leong

2012

Aliment Pharmacol Ther

119

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“…The link between smoking and (IBD) was first made in 1982 when Harries et al [6] noticed a low proportion of ulcerative colitis patients were smokers. Two years later a case-control study by Somerville et al [7] reported that the relative risk of developing Crohn's disease was 4.8 in those who smoked before disease onset, and 3.5 for those with a current smoking habit.…”

Section: Introductionmentioning

confidence: 99%

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Lakatos¹

2007

WJG

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Smoking is an important environmental factor in inflammatory bowel disease (IBD), having different effects in ulcerative colitis (UC) and Crohn's disease (CD). A recent meta-analysis partially confirmed previous findings that smoking was found to be p r o t e c t i v e a g a i n s t u l c e r a t i v e c o l i t i s a n d , a f t e r onset of the disease, might improve its course, d e c r e a s i n g t h e n e e d f o r c o l e c t o m y . H o w e v e r , smoking increases the risk of developing Crohn's disease and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves Crohn's disease. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

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“…The first report on non-smoking as a risk factor in UC was published in 1982, and several more have confirmed this observation [84]. Smoking is associated with lower onset risk, fewer hospitalizations, lower relapse rate and decreased need for colectomy in UC [85][86][87].…”

Section: Ucmentioning

confidence: 84%

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

Molnár¹

2014

J Clin Cell Immunol

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The pathogenesis of inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn's disease (CD) is complex, and our knowledge on the topic is constantly growing. The two disorders are distinct, yet overlap in their clinical manifestations and underlying causes. This review aims to provide a broad overview of the numerous pathogenetic factors that can lead to the development of IBD, focusing on novel findings and on the differences between UC and CD. Recent advances in genetics have identified new components in the pathogenesis, as an example, the importance of Th17 lymphocytes and the IL-17/IL-23 pathway have been highlighted in both diseases, apart from the previously known Th1-Th2 driven processes. Genetic background of increased permeability has been explored in UC, and the role of defective autophagy was recently described in CD. Genetic alterations can lead to an exaggerated immune response to the resident microbial flora. This microflora is altered in IBD patients, probably due to their reduced ability to stabilize its bacterial components and due to different environmental factors. An exhaustive exploration of environmental factors is particularly important, as they can be influential in many cases. The impact of smoking is the most established environmental factor, having deleterious effects in CD and protective in UC. Recent opinions on other factors, such as early appendectomy, diet, reduced vitamin D levels, the use of specific medications, breastfeeding, personal hygiene and psychological factors are also discussed. Epigenetics, a new field of research, links environmental factors to genetics. Understanding these factors is of great significance as changing lifestyles and improving life circumstances have started to increase the prevalence of IBD also in developing countries.

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Non-smoking: a feature of ulcerative colitis.

Cited by 307 publications

References 3 publications

Review article: ulcerative colitis, smoking and nicotine therapy

Review article: ulcerative colitis, smoking and nicotine therapy

Smoking in inflammatory bowel diseases: Good, bad or ugly?

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

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