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Related Concept Videos

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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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...
349
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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

528
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...
528
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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

313
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...
313
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

719
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...
719
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

317
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...
317
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  11. Discovery Of Biomarker Candidates Associated With The Risk Of Short-term And Mid/long-term Relapse After Infliximab Withdrawal In Crohn's Patients: A Proteomics-based Study

Discovery of biomarker candidates associated with the risk of short-term and mid/long-term relapse after infliximab withdrawal in Crohn's patients: a proteomics-based study

Nicolas Pierre1, Dominique Baiwir2, Vân Anh Huynh-Thu3

  • 1Laboratory of Translational Gastroenterology, GIGA-Institute, Liege University, Liege, Belgium nicolas.pierre@uliege.be.

Gut
|October 27, 2020

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View abstract on PubMed

Summary
This summary is machine-generated.

New biomarkers can predict mid/long-term relapse in Crohn's disease (CD) patients after infliximab withdrawal. These novel markers offer a non-invasive way to assess relapse risk, improving patient management.

Area of Science:

  • Gastroenterology
  • Immunology
  • Proteomics

Background:

  • Crohn's disease (CD) management involves infliximab therapy.
  • A subset of CD patients achieves remission upon infliximab withdrawal.
  • Identifying patients at risk for relapse after infliximab discontinuation is crucial.

Purpose of the Study:

  • To discover novel circulating biomarkers for predicting relapse in CD patients discontinuing infliximab.
  • To differentiate between short-term and mid/long-term relapse prediction.
  • To evaluate the predictive capacity of novel biomarkers compared to current standards.

Main Methods:

  • Analysis of baseline serum samples from 102 CD patients in stable remission on combined therapy (diSconTinuation in CrOhn's disease patients in stable Remission on combined therapy with Immunosuppressors cohort).
Keywords:
Crohn's diseaseIBD clinicalclinical decision makinginflammatory bowel disease

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  • Shotgun proteomics for biomarker discovery and selected reaction monitoring for verification.
  • Stratification of datasets to identify markers for short-term (<6 months) and mid/long-term (>6 months) relapse.
  • Univariate Cox model and log-rank statistics for risk and prediction evaluation.

    • Main Results:

    • Distinct sets of 15 and 17 protein biomarker candidates were identified for short-term and mid/long-term relapse risk, respectively.
    • Novel biomarker combinations demonstrated superior predictive capacity (higher Z-scores, FDR <0.001) compared to C-reactive protein and fecal calprotectin.
    • Identified biomarkers reflect different pathophysiological processes associated with relapse.

    Conclusions:

    • First identification of circulating biomarkers predicting mid/long-term relapse risk in CD patients after infliximab withdrawal.
    • Findings suggest a sequence of pathophysiological events preceding relapse, aiding disease progression understanding.
    • These biomarkers may enable non-invasive risk assessment for infliximab withdrawal in CD patients.
    infliximab