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Author(s)
Geboes-K, Dalle-I.
Author affiliation
Department of Pathology, University
of Leuven, Belgium.
Karel.Geboes@uz.kuleuven.ac.be.
Title
Influence of treatment on morphological features of mucosal
inflammation.
Source
Gut {Gut} 2002 May, VOL: 50 Suppl 3, P: III37-42, Refs: 85, ISSN:
0017-5749.
Language English.
Publication type
Journal-Article, Review, Review-Tutorial.
MeSH headings
ADULT;
ANTI-INFLAMMATORY-AGENTS-NON-STEROIDAL/TU (therapeutic use);
ASPIRIN/TU (therapeutic use);
CHILD;
COLITIS-ULCERATIVE/DT (drug therapy), PA (pathology);
CROHN-DISEASE/DT (drug therapy), PA (pathology);
DIAGNOSIS-DIFFERENTIAL;
GASTRIC-MUCOSA/*DE (drug effects), PA (pathology);
GASTRITIS/*DT (drug therapy), PA (pathology);
GLUCOCORTICOIDS-SYNTHETIC/TU (therapeutic use)
; HUMAN;
INFLAMMATORY-BOWEL-DISEASES/*DT (drug therapy), PA (pathology);
INTESTINAL-MUCOSA/*DE (drug effects), PA (pathology).
CAS Registry numbers
0 (Anti-Inflammatory-Agents-Non-Steroidal);
0 (Glucocorticoids-Synthetic);
50-78-2 (Aspirin).
Abstract
Microscopic analysis of endoscopically obtained
tissue samples is important for the diagnosis of several gastrointestinal
disorders such as gastritis and chronic inflammatory bowel disease (IBD). Histologically
disease activity is based on the presence of neutrophilic polymorphonuclear
leucocytes in conjunction with epithelial damage. Effective eradication
treatment for Helicobacter pylori related gastritis reduces active
inflammation rapidly whereas chronic inflammation decreases only slowly. Similar
findings have been obtained for IBD. A literature review of clinical drug
trials in IBD and the effect of various drugs on the microscopic features
of Crohn's disease and immunohistochemistry for different markers was
performed. Diagnostic microscopic features and the features characteristic
for disease activity vary with time and treatment. The more recently
developed drugs used for Crohn's disease can induce mucosal healing.
Journal subset
AIM; IM. Publication year 2002.
Country of publisher
England.
Author(s)
Falasco-G, Zinicola-R, Forbes-Alastair.
Author affiliation
Department of Gastroenterology, St Mark's Hospital, Watford
Road, Harrow, HA1
3UJ, UK.
Title
Review article: Immunosuppressants in distal ulcerative colitis.
Source
Alimentary pharmacology & therapeutics {Aliment-Pharmacol-Ther}
2002 Feb, VOL: 16 (2), P: 181-7, Refs: 26, ISSN: 0269-2813.
Language English.
Publication type Journal-Article, Review, Review-Tutorial.
MeSH headings
6-MERCAPTOPURINE/AE (adverse effects), TU
(therapeutic use);
ADULT;
AGED;
AZATHIOPRINE/AE (adverse effects), TU (therapeutic use);
COLITIS-ULCERATIVE/*DT (drug therapy), SU (surgery);
CYCLOSPORINE/AE (adverse effects), TU (therapeutic use);
DATABASES-FACTUAL;
FEMALE;
HUMAN;
IMMUNOSUPPRESSIVE-AGENTS/AE (adverse effects), *TU (therapeutic use);
MALE;
MIDDLE-AGE;
TREATMENT-OUTCOME.
CAS Registry numbers
0 (Immunosuppressive-Agents);
446-86-6 (Azathioprine);
50-44-2 (6-Mercaptopurine);
59865-13-3 (Cyclosporine).
Abstract
BACKGROUND: Distal ulcerative colitis may
prove to be resistant to steroids and aminosalicylates, but total colectomy
is more difficult to justify than in severe extensive colitis. Immunosuppression
is of established benefit in generalized colitis, but there are no data
available specific to distal disease. AIM: To determine whether the
protocol-driven use of immunosuppressants in resistant distal ulcerative
colitis is of similar efficacy and safety to that in extensive disease. METHODS:
Two hundred and twenty-eight patients with distal ulcerative colitis seen
in a 5-year period were identified from a prospective database. Details of
52 who had received immunosuppression were analysed. RESULTS: The 52
patients received 68 courses of therapy (53 azathioprine, five
mercaptopurine, 10 ciclosporin). The thiopurines yielded clinically
valuable responses in only 43% of courses, with failure of response in 16%
and toxicity in 34%. Ciclosporin was helpful on only two of 10 occasions.
Eight patients required total colectomy. Adverse events were typical of
those normally associated with immunosuppressants, with potential risk to
life in seven patients; treatment was discontinued because of toxicity on a
total of 31% of occasions. CONCLUSIONS: Immunosuppression appears to be of
lower efficacy and higher toxicity in resistant distal colitis than when
used in more extensive colitis.
Journal subset IM.
Publication year 2002.
Country of publisher
England. 
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