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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
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Inflammatory Bowel Disease I: Ulcerative Colitis

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Mycophenolate induced diarrhoea.

Ashwinikumar Aiyangar1, Prashant Rajput, Bharat V Shah

  • 1Lilavati Hospital, Mumbai.

The Journal of the Association of Physicians of India
|September 21, 2010
PubMed
Summary
This summary is machine-generated.

Mycophenolate mofetil (MMF) can cause chronic diarrhea, potentially due to low inosine monophosphate dehydrogenase (IMPDH) enzyme levels. Discontinuing MMF and adding folic acid improved symptoms in patients, suggesting a link between MMF and gastrointestinal issues.

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Area of Science:

  • Immunology
  • Pharmacology
  • Gastroenterology

Background:

  • Mycophenolate mofetil (MMF) is a key immunosuppressant.
  • Gastrointestinal disturbances, particularly diarrhea, and bone marrow suppression are primary MMF side effects.
  • The exact mechanism of MMF-induced diarrhea remains unclear.

Observation:

  • Three patients on MMF presented with chronic diarrhea.
  • Diagnostic evaluations included complete blood count, stool analysis, cultures, endoscopy, and biopsy.
  • Histopathology revealed villous atrophy in all three patients.

Findings:

  • Discontinuation of MMF and supplementation with folic acid led to symptom resolution.
  • This suggests a direct relationship between MMF use and the observed diarrhea.
  • The complication's rarity may indicate a genetic predisposition, possibly linked to lower inosine monophosphate dehydrogenase (IMPDH) enzyme levels.

Implications:

  • MMF-induced diarrhea might be linked to the drug's mechanism of action involving IMPDH.
  • Lower IMPDH levels could predispose individuals to this specific side effect.
  • This finding warrants further investigation into genetic factors influencing MMF tolerance and adverse effects.