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Medikamentöse Therapie der Colitis


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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