Vedolizumab-associated diffuse interstitial lung disease in patients with ulcerative colitis: A case report

Zhang, Jie; Liu, Meihong; Gao, Xue; Dong, Changfeng; Li, Yanxia

doi:10.12998/wjcc.v10.i5.1716

Cited by 5 publications

(3 citation statements)

References 19 publications

(15 reference statements)

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“…The purpose of our case report is to show the possibility that Vedolizuamb causes pulmonary hemorrhage such as many other monoclonal antibodies to different farmodynamics like Infliximab, Ustekinumab and others [9,18,20]. In fact, rapid onset pulmonary manifestations are known, which if caught in time can be managed safely for the patient [19,20].…”

Section: Discussionmentioning

confidence: 99%

Fatal Diffuse Alveolar Hemorrhage (DAH) Secondary to Monoclonal Antibody Therapy in a Young Patient with Ulcerative Colitis (UC): An Autopsy Case

Argo,

Lo Rito,

Guadagnino

et al. 2024

Preprint

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Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Fatal Diffuse Alveolar Hemorrhage (DAH) Secondary to Monoclonal Antibody Therapy in a Young Patient with Ulcerative Colitis (UC): An Autopsy Case

Argo,

Lo Rito,

Guadagnino

et al. 2024

Preprint

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show abstract

“…Numerous studies have demonstrated its efficacy in treating IBD; for instance, an analysis of homing receptor expression on T cells in peripheral blood and inflamed mucosa showed that treatment with vedolizumab is associated with a significant expansion of regulatory T cells in peripheral blood without a significant increase in viral infections in the IBD group ( 33 ). Therefore, as the only gut-selective biologic that specifically targets the α4β7 gastrointestinal integrin receptor, vedolizumab represents a promising therapeutic option for IBD ( 34 ). Ustekinumab, a human IgG antibody targeting the p40 subunit common to both IL-12 and IL-23, operates differently from anti-TNF therapies ( 35 ).…”

Section: Treatment Methods For Ibdmentioning

confidence: 99%

Advances and optimization strategies in bacteriophage therapy for treating inflammatory bowel disease

Li,

Duan

et al. 2024

Front. Immunol.

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In the advancement of Inflammatory Bowel Disease (IBD) treatment, existing therapeutic methods exhibit limitations; they do not offer a complete cure for IBD and can trigger adverse side effects. Consequently, the exploration of novel therapies and multifaceted treatment strategies provides patients with a broader range of options. Within the framework of IBD, gut microbiota plays a pivotal role in disease onset through diverse mechanisms. Bacteriophages, as natural microbial regulators, demonstrate remarkable specificity by accurately identifying and eliminating specific pathogens, thus holding therapeutic promise. Although clinical trials have affirmed the safety of phage therapy, its efficacy is prone to external influences during storage and transport, which may affect its infectivity and regulatory roles within the microbiota. Improving the stability and precise dosage control of bacteriophages—ensuring robustness in storage and transport, consistent dosing, and targeted delivery to infection sites—is crucial. This review thoroughly explores the latest developments in IBD treatment and its inherent challenges, focusing on the interaction between the microbiota and bacteriophages. It highlights bacteriophages’ potential as microbiome modulators in IBD treatment, offering detailed insights into research on bacteriophage encapsulation and targeted delivery mechanisms. Particular attention is paid to the functionality of various carrier systems, especially regarding their protective properties and ability for colon-specific delivery. This review aims to provide a theoretical foundation for using bacteriophages as microbiome modulators in IBD treatment, paving the way for enhanced regulation of the intestinal microbiota.

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“…By withholding vedolizumab and giving steroid therapy, the patient was successfully treated [156]. Recently, other case reports documented the possibility of vedolizumab-induced lung injury [157][158][159].…”

Section: Vedolizumabmentioning

confidence: 99%

Lung Involvement in Inflammatory Bowel Diseases: Shared Pathways and Unwanted Connections

Cavalli,

Gabbiadini,

Dal Buono

et al. 2023

JCM

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Inflammatory bowel diseases (IBDs) are chronic, relapsing inflammatory disorders of the gastrointestinal tract, frequently associated with extraintestinal manifestations (EIMs) that can severely affect IBD patients’ quality of life, sometimes even becoming life-threatening. Respiratory diseases have always been considered a rare and subsequently neglected extraintestinal manifestations of IBD. However, increasing evidence has demonstrated that respiratory involvement is frequent in IBD patients, even in the absence of respiratory symptoms. Airway inflammation is the most common milieu of IBD-related involvement, with bronchiectasis being the most common manifestation. Furthermore, significant differences in prevalence and types of involvement are present between Crohn’s disease and ulcerative colitis. The same embryological origin of respiratory and gastrointestinal tissue, in addition to exposure to common antigens and cytokine networks, may all play a potential role in the respiratory involvement. Furthermore, other causes such as drug-related toxicity and infections must always be considered. This article aims at reviewing the current evidence on the association between IBD and respiratory diseases. The purpose is to raise awareness of respiratory manifestation among IBD specialists and emphasize the need for identifying respiratory diseases in early stages to promptly treat these conditions, avoid worsening morbidity, and prevent lung damage.

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Vedolizumab-associated diffuse interstitial lung disease in patients with ulcerative colitis: A case report

Cited by 5 publications

References 19 publications

Fatal Diffuse Alveolar Hemorrhage (DAH) Secondary to Monoclonal Antibody Therapy in a Young Patient with Ulcerative Colitis (UC): An Autopsy Case

Fatal Diffuse Alveolar Hemorrhage (DAH) Secondary to Monoclonal Antibody Therapy in a Young Patient with Ulcerative Colitis (UC): An Autopsy Case

Advances and optimization strategies in bacteriophage therapy for treating inflammatory bowel disease

Lung Involvement in Inflammatory Bowel Diseases: Shared Pathways and Unwanted Connections

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