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Related Concept Videos

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 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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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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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.
Pharmacologic...
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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 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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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

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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...
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Related Experiment Video

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Injections of Lipopolysaccharide into Mice to Mimic Entrance of Microbial-derived Products After Intestinal Barrier Breach
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[Immune Checkpoint Inhibitor Related Enterocolitis].

Yasuo Hamamoto1

  • 1Division of Gastroenterology and Hepatology, Dept. of Internal Medicine, Keio University School of Medicine.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|May 9, 2020
PubMed
Summary

Immune checkpoint inhibitors (ICI) treat cancer but can cause immune-related adverse events (irAEs). Enterocolitis, a severe irAE, is more common with combination therapies like anti-CTLA-4 and anti-PD-1 antibodies.

Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used for various cancers.
  • Immune-related adverse events (irAEs), including enterocolitis, are significant concerns with ICI therapy.
  • Enterocolitis is a major irAE, particularly associated with anti-CTLA-4 antibody treatment.

Purpose of the Study:

  • To summarize current knowledge on the clinical features of ICI-induced enterocolitis.
  • To discuss the risks associated with combination ICI therapies (anti-CTLA-4 and anti-PD-1/PD-L1).
  • To explore future perspectives in managing ICI-related enterocolitis.

Main Methods:

  • Review of accumulated evidence on ICI-induced enterocolitis.
  • Analysis of clinical features associated with anti-CTLA-4 and anti-PD-1/PD-L1 antibodies.

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  • Synthesis of current knowledge and identification of research gaps.

    • Main Results:

    • Enterocolitis is a significant irAE of ICIs, especially anti-CTLA-4 therapy.
    • Combination therapy (anti-CTLA-4 and anti-PD-1) increases enterocolitis risk compared to monotherapy.
    • Distinct clinical features of enterocolitis have been identified for different ICI agents.

    Conclusions:

    • Understanding ICI-induced enterocolitis is crucial for patient safety.
    • Risk stratification and management strategies are needed, particularly for combination therapies.
    • Further research is required to optimize the use of ICIs while mitigating irAEs like enterocolitis.