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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
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...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

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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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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
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Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...

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Fluorescence-mediated Tomography for the Detection and Quantification of Macrophage-related Murine Intestinal Inflammation
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Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naïve patients with ulcerative

M De Vos1, O Dewit, G D'Haens

  • 1Ghent University Hospital, Gent, Belgium. martine.devos@ugent.be

Journal of Crohn'S & Colitis
|March 9, 2012
PubMed
Summary
This summary is machine-generated.

Infliximab induction therapy rapidly reduced fecal calprotectin in ulcerative colitis patients. This decrease predicted endoscopic and clinical remission, highlighting its utility in monitoring treatment response.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Monitoring disease activity and treatment response in UC is crucial.
  • Faecal calprotectin is a validated biomarker for intestinal inflammation.

Purpose of the Study:

  • To assess the impact of infliximab induction therapy on faecal calprotectin levels in UC patients.
  • To determine if early changes in calprotectin correlate with treatment outcomes.

Main Methods:

  • Prospective study of 53 active UC patients treated with infliximab (5 mg/kg) at weeks 0, 2, and 6.
  • Weekly measurement of faecal calprotectin.
  • Sigmoidoscopy at baseline, week 6, and week 10 to assess endoscopic remission.

Main Results:

  • Median calprotectin levels significantly decreased from 1260 to 72.5 (p<0.001) by week 10.
  • 58% of patients achieved endoscopic remission and significant calprotectin reduction (<50 mg/kg or ≥80% decrease).
  • Early calprotectin decrease at week 2 predicted week 10 endoscopic remission (p<0.001).

Conclusions:

  • Infliximab therapy induces a rapid and significant reduction in faecal calprotectin in anti-TNF-naïve UC patients.
  • Faecal calprotectin decrease is predictive of disease remission.
  • Calprotectin levels correlate strongly with endoscopic and clinical remission.