Treatment for acute severe ulcerative colitis

Leake, Isobel

doi:10.1038/nrgastro.2016.112

Cited by 2 publications

(6 citation statements)

References 1 publication

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“…If treatment is ineffective or exacerbates the condition, immunosuppressive agents such as cyclosporine A or the blocking of the secretion of the pro-inflammatory cytokine TNFα with infliximab are used for emergency intravenous infusion treatment. Partial colectomy is considered if treatment is no longer effective [2,4,7,[54][55][56]. It is important to further summarize these clinical studies, and the glucocorticoid treatment of acute ulcerative colitis, especially in the development of acute ulcerative colitis, is often ineffective or even detrimental.…”

Section: Discussionmentioning

confidence: 99%

“…Histological colitis scores were determined as previously described [3,36]. In brief, histological sections were scored as follows: epithelium: normal morphology (0), loss of goblet cells (1), loss of goblet cells in large areas (2), loss of crypts (3) and loss of crypts in large areas (4); infiltration: no infiltrate (0), infiltrate around crypts (1), infiltrate reaching the lamina muscularis mucosae (2), extensive infiltration reaching the lamina muscularis mucosae and thickening of the mucosa (3) and infiltration of the submucosal layer (4). The total histological score represents the sum of both scores and ranges from 0 to 8.…”

Section: Experimental Colitis and Histological Analysesmentioning

confidence: 99%

“…It is urgent and serious. The lesions are mostly seen in the sigmoid colon and rectum and can also extend to the descending colon or even the entire colon [1][2][3][4]. To alleviate acute colitis, treatment with effective drugs and deciding upon selective colectomy in a timely fashion are necessary [1,2,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…The lesions are mostly seen in the sigmoid colon and rectum and can also extend to the descending colon or even the entire colon [1][2][3][4]. To alleviate acute colitis, treatment with effective drugs and deciding upon selective colectomy in a timely fashion are necessary [1,2,[4][5][6]. Acute ulcerative colitis is poorly controlled and often develops into chronic colitis and inflammatory-related cancer, even leading to death [3,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…At present, glucocorticoids are the first-line drug for colitis treatment [2,3]. If there is no response or exacerbation in 3-5 days, the use of either the immunosuppressive drug cyclosporine (2 mg/kg, intravenous (IV)) or the anti-TNFα antibody drug infliximab (5 mg/kg IV) should be considered [1,3,4,10]. Known controlled evidence supports the use of both treatments.…”

Section: Introductionmentioning

confidence: 99%

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Glucocorticoids Promote the Onset of Acute Experimental Colitis and Cancer by Upregulating mTOR Signaling in Intestinal Epithelial Cells

Zhang

Lin

Jia

et al. 2020

Cancers

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The therapeutic effects of glucocorticoids on colitis and colitis-associated cancer are unclear. In this study, we investigated the therapeutic roles of glucocorticoids in acute experimental ulcerative colitis and colitis-associated cancer in mice and their immunoregulatory mechanisms. Murine acute ulcerative colitis was induced by dextran sulfate sodium (DSS) and treated with dexamethasone (Dex) at different doses. Dex significantly exacerbated the onset and severity of DSS-induced colitis and potentiated mucosal inflammatory macrophage and neutrophil infiltration, as well as cytokine production. Furthermore, under inflammatory conditions, the expression of the glucocorticoid receptor (GR) did not change significantly, while mammalian target of rapamycin (mTOR) signaling was higher in colonic epithelial cells than in colonic immune cells. The deletion of mTOR in intestinal epithelial cells, but not that in myeloid immune cells, in mice significantly ameliorated the severe course of colitis caused by Dex, including weight loss, clinical score, colon length, pathological damage, inflammatory cell infiltration and pro-inflammatory cytokine production. These data suggest that mTOR signaling in intestinal epithelial cells, mainly mTORC1, plays a critical role in the Dex-induced exacerbation of acute colitis and colitis-associated cancer. Thus, these pieces of evidence indicate that glucocorticoid-induced mTOR signaling in epithelial cells is required in the early stages of acute ulcerative colitis by modulating the dynamics of innate immune cell recruitment and activation.

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Section: Discussionmentioning

confidence: 99%

Section: Experimental Colitis and Histological Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Glucocorticoids Promote the Onset of Acute Experimental Colitis and Cancer by Upregulating mTOR Signaling in Intestinal Epithelial Cells

Zhang

Lin

Jia

et al. 2020

Cancers

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Peripheral blood miR‑372 as a biomarker for ulcerative colitis via direct targeting of NLRP12

Shen

2019

Exp Ther Med

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The present study aimed to investigate the expression pattern and underlying mechanism of microRNA-372 (miR-372) in the progression of ulcerative colitis (UC). Reverse transcription-quantitative polymerase chain reaction was used to measure miR-372 expression levels in the blood and colonic mucosa tissue samples from patients with UC. The present study demonstrated that levels of miR-372 were significantly increased in the blood and colonic mucosa tissue samples from patients with UC compared with healthy controls. Furthermore, the level of serum miR-372 was positively correlated with the level of serum c-reactive protein. Receiver operating characteristic analysis indicated that levels of miR-372 detected in serum and tissue samples could be used to screen for patients with UC from healthy controls. These results indicated a potential role of miR-372 as a diagnostic marker and therapeutic target for patients with UC. Furthermore, a conserved miR-372 binding site in the 3'untranslated region of the NLR family pyrin domain containing 12 (NLRP12) was identified. Dual luciferase assay demonstrated that overexpression of miR-372 significantly reduced the relative luciferase activity of pmirGLO-NLRP12-3'UTR compared with control pmirGLO. In addition, western blot analysis indicated that overexpression of miR-372 significantly decreased the protein expression level of NLRP12. Therefore it was hypothesized that miR-372 may promote the progression of UC by suppressing NLRP12 protein expression and thereby inducing the excessive production of inflammatory cytokines. In conclusion, high levels of miR-372 detected in peripheral blood samples may serve a role as a potential biomarker to screen potential patients with UC from healthy controls.

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Treatment for acute severe ulcerative colitis

Cited by 2 publications

References 1 publication

Glucocorticoids Promote the Onset of Acute Experimental Colitis and Cancer by Upregulating mTOR Signaling in Intestinal Epithelial Cells

Glucocorticoids Promote the Onset of Acute Experimental Colitis and Cancer by Upregulating mTOR Signaling in Intestinal Epithelial Cells

Peripheral blood miR‑372 as a biomarker for ulcerative colitis via direct targeting of NLRP12

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