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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.
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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...
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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...
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Screening Assays to Characterize Novel Endothelial Regulators Involved in the Inflammatory Response
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Can early therapy reduce inflammation?

Netanya G Sandler1, Irini Sereti

  • 1aInfectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas bLaboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.

Current Opinion in HIV and AIDS
|November 20, 2013
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Summary
This summary is machine-generated.

Persistent inflammation in HIV patients on combination antiretroviral therapy (ART) predicts serious non-AIDS events. Biomarkers of inflammation are key to identifying high-risk individuals for improved therapeutic strategies.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Public Health

Background:

  • Serious non-AIDS events and noninfectious complications are more common than AIDS events in the current combination antiretroviral therapy (ART) era for HIV infection.
  • Chronic inflammation is the primary driver of these non-AIDS events, necessitating a deeper understanding of persistent inflammation during ART.
  • Understanding the mechanisms of persistent inflammation is crucial for developing improved therapeutic strategies and optimizing ART initiation timing.

Purpose of the Study:

  • To investigate the role of persistent inflammation in driving non-AIDS events in HIV-infected individuals on ART.
  • To identify reliable biomarkers for predicting non-AIDS outcomes and mortality in treated HIV infection.
  • To explore the potential of inflammation markers as surrogate endpoints for clinical trials and to guide therapeutic interventions.

Main Methods:

  • Review of current literature on inflammation markers and their association with non-AIDS outcomes in HIV-infected individuals.
  • Analysis of studies examining the impact of ART initiation timing on inflammation levels.
  • Evaluation of the predictive value of various inflammation and coagulation markers (e.g., D-dimer, IL-6, CRP) and T-cell activation markers.

Main Results:

  • Markers of inflammation and coagulation (D-dimer, IL-6, CRP, sCD14, sCD163) are strong predictors of end-organ disease and mortality.
  • T-cell activation markers are more predictive of CD4 T-cell decline, AIDS events, or treatment response.
  • Initiating ART at higher CD4 T-cell counts may reduce inflammation, though antiretroviral drugs can differentially affect inflammatory pathways.

Conclusions:

  • Circulating inflammation biomarkers are potent predictors of non-AIDS outcomes in treated HIV infection.
  • These biomarkers may evolve into surrogate endpoints for end-organ disease, aiding in risk stratification.
  • Identifying high-risk patients could facilitate early ART initiation and the development of adjuvant anti-inflammatory therapies.