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Related Concept Videos

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

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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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Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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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...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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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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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Immune-Mediated Colitis.

Tara Menon1, Anita Afzali2

  • 1The Ohio State University Inflammatory Bowel Disease Center, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. tara.menon@osumc.edu.

Current Treatment Options in Gastroenterology
|November 20, 2019
PubMed
Summary
This summary is machine-generated.

Immune-mediated colitis (IMC) management mirrors inflammatory bowel disease (IBD) approaches. Immune checkpoint inhibitors (ICIs) can cause IMC, yet standardized management guidelines are lacking.

Keywords:
CTLA-4Immune checkpoint inhibitorImmune-mediated colitisImmune-related adverse eventsPD-1PD-L1

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Area of Science:

  • Gastroenterology
  • Immunology
  • Oncology

Background:

  • Immune-mediated colitis (IMC) shares clinical, endoscopic, and histologic features with inflammatory bowel disease (IBD).
  • Gastroenterologists often adapt IBD management strategies for IMC.
  • Immune checkpoint inhibitors (ICIs) are crucial cancer therapies but can cause immune-related adverse events (irAEs).

Purpose of the Study:

  • To review current knowledge of immune-mediated colitis (IMC).
  • To provide a practical management guide for IMC, particularly irAEs from ICIs.

Main Methods:

  • Literature review of immune-mediated colitis and immune checkpoint inhibitor-related adverse events.
  • Analysis of clinical, endoscopic, and histologic findings.

Main Results:

  • Diarrhea and IMC are the most frequent and severe irAEs associated with ICIs.
  • No established guidelines currently exist for managing ICI-induced IMC.
  • Management strategies for IMC often parallel those used for IBD.

Conclusions:

  • Standardized guidelines are needed for managing immune checkpoint inhibitor-induced colitis.
  • Further research is required to optimize IMC treatment protocols.