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Related Concept Videos

Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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),...
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 Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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),...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
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...

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In Vivo Augmentation of Gut-Homing Regulatory T Cell Induction
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Biologic therapy in inflammatory bowel disease.

Klaus Theede1, Jens Frederik Dahlerup, Jan Fallingborg

  • 1Gastrounit, Medical Section 360, Hvidovre Hospital, 2650 Hvidovre, Denmark. klaus.theede@regionh.dk

Danish Medical Journal
|June 8, 2013
PubMed
Summary

Biologic therapies like infliximab and adalimumab offer treatment options for moderate to severe Crohn's disease and ulcerative colitis. Regular monitoring and assessment are crucial for managing these inflammatory bowel diseases effectively.

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Development of an Antigen-driven Colitis Model to Study Presentation of Antigens by Antigen Presenting Cells to T Cells
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Development of an Antigen-driven Colitis Model to Study Presentation of Antigens by Antigen Presenting Cells to T Cells

Published on: September 18, 2016

Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Conventional therapies for inflammatory bowel disease (IBD) include systemic steroids and immunosuppressants.
  • Treatment failure or intolerance to conventional therapies necessitates alternative treatment strategies.
  • Biologic agents such as infliximab and adalimumab have emerged as key therapeutic options for IBD.

Purpose of the Study:

  • To outline the treatment strategies for luminal and fistulising Crohn's disease using infliximab and adalimumab.
  • To describe the management of acute severe and chronic active ulcerative colitis with biologic agents.
  • To emphasize the importance of monitoring treatment efficacy, response, and potential complications.

Main Methods:

  • Review of current treatment guidelines and evidence for biologic therapies in IBD.
  • Evaluation of treatment strategies based on disease manifestation (luminal, fistulising, acute/chronic active).
  • Assessment of treatment efficacy through clinical, paraclinical, endoscopic, and imaging parameters.

Main Results:

  • Infliximab and adalimumab are indicated for moderate to severe luminal Crohn's disease refractory to conventional therapy.
  • These biologics are also used for fistulising Crohn's disease and both acute severe and chronic active ulcerative colitis.
  • Treatment efficacy requires regular evaluation (every 26-52 weeks) and monitoring for complications like infections and infusion reactions.

Conclusions:

  • Treatment strategy for IBD with biologics is guided by initial response to induction therapy and disease phenotype.
  • Maintenance therapy is often necessary, particularly in complex fistulising Crohn's disease.
  • Close monitoring for efficacy and adverse events is essential throughout biologic treatment for IBD.