Postoperative Change of Mucosal Inflammation at Strictureplasty Segment in Crohn's Disease: Cytokine Production and Endoscopic and Histologic Findings

Yamamoto, Takayuki; Umegae, Satoru; Kitagawa, Tatsushi; Matsumoto, Koichí

doi:10.1007/s10350-004-0826-2

Cited by 24 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[25][26][27] Yamamoto et al 28 suggested that relieving the bowel obstruction with high pressure can drive bacteria and allergens into CD lesions, which would lead to downregulation of the mucosal immune system, followed by infl ammatory regression after an SP. These may also be related to the low rate of recurrence after SP in the current study.…”

Section: Discussionmentioning

confidence: 99%

Long-term efficacy of strictureplasty for Crohn’s disease

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term efficacy of strictureplasty for Crohn’s disease

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The dysfunction of the lymphatic vessels could have an essential role in inducing and maintaining chronic inflammation in CD, similarly to other pathological clinical or experimental situations [18] . On the other hand, the lymphatic vessels play a fundamental part in the resolution of inflammation by draining the activated inflammatory cells into the mesenterial lymph nodes and transporting extravasated fluids from interstitial tissue into circulating blood.…”

Section: Discussionmentioning

confidence: 99%

Is lymphatic status related to regression of inflammation in Crohn's disease?

Tonelli

Giudici²,

Liscia³

2012

WJGS

View full text Add to dashboard Cite

AIM:To investigate the status of the lymphatic vessels in the small bowel affected by Crohn's disease (CD) at the moment of surgery. METHODS:During the period January 2011-June 2011, 25 consecutive patients affected by CD were operated on in our Institution. During surgery, Patent Blue Ⅴ was injected subserosally and the way it spread along the subserosa of the intestinal wall, through the mesenterial layers towards the main lymphatic collectors and eventually to the lymph nodes was observed and recorded. Since some patients had been undergone strictureplasty at previous surgery, we also examined the status of intestinal lymph vessels after previous strictureplasties. The same procedure was performed in a control group of 5 patients affected by colorectal cancer. Length of lesions, caliber, maximal thickness of the diseased intestinal wall, thickness of the wall at injection site and thickness of the mesentery were evaluated at surgery. RESULTS:We observed three features after the injection of Patent Blue Ⅴ in the intestinal loops: (1) Macroscopically healthy terminal ileum of patients with CD or colon cancer showed thin lymphatic vessels linearly directed toward the mesentery; (2) In mild lesions in which the intestinal wall did not reach 8 mm of thickness, we observed short, wide and tortuous lymphatic vessels directed longitudinally along the intestinal axis toward disease-free areas and then transversally toward the mesentery; and (3) Injection in the severely affected lesions, that had a thickness of the intestinal wall over 10 mm, did not show any feature of lymphatic vessels at least on the subserosal surface. There was a correlation between the thickness of the parietal wall and the severity of the lymphatic alterations. Normal lymphatic vessels were observed at previous strictureplasties in the presence of complete regression of the inflammation. CONCLUSION:Injection of Patent Blue Ⅴ in the intestinal wall could help distinguish healthy tracts of the small bowel from those macroscopically borderline.

show abstract

“…Our hypothesis for the mechanism of inflammatory regression after strictureplasty is that by relieving bowel obstruction the enteric content is not under high pressure to drive bacterium and food allergen into the ulcerations or fissures of the intestinal wall, thereby the mucosal immune system is down-regulated. 108 Further studies are necessary to clarify the mechanism by which the regression of disease might occur after strictureplasty.…”

Section: Mechanism Of Inflammatory Regression After Strictureplastymentioning

confidence: 99%

“…107 The mechanism of inflammatory regression at the strictureplasty site remains unknown. In the first author_s study in Japan, 108 to examine postoperative change of mucosal inflammation at the strictureplasty site, biopsy specimens were taken at endoscopy. During one year after strictureplasty, cytokine production at the strictureplasty site was decreased to the level of the macroscopically normal ileum.…”

Section: Mechanism Of Inflammatory Regression After Strictureplastymentioning

confidence: 99%

Safety and Efficacy of Strictureplasty for Crohn's Disease: A Systematic Review and Meta-Analysis

Yamamoto

Fazio

Tekkis

2007

Diseases of the Colon &Amp; Rectum

Self Cite

270

136

View full text Add to dashboard Cite

show abstract

Postoperative Change of Mucosal Inflammation at Strictureplasty Segment in Crohn's Disease: Cytokine Production and Endoscopic and Histologic Findings

Abstract: During one year after strictureplasty for Crohn's disease, cytokine production at the strictureplasty segment was decreased to the level of the macroscopically normal ileum and an imbalance between proinflammatory and antiinflammatory cytokines was corrected.

Cited by 24 publications

References 28 publications

Long-term efficacy of strictureplasty for Crohn’s disease

Long-term efficacy of strictureplasty for Crohn’s disease

Is lymphatic status related to regression of inflammation in Crohn's disease?

Safety and Efficacy of Strictureplasty for Crohn's Disease: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About