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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

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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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Inflammatory Bowel Disease IV: Pharmacological Management01:29

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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 Crohn's Disease in IBD Using Immunomodulatory Agents01:29

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

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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...
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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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Toward Precision Medicine: Molecular Biomarkers of Response to Tofacitinib in Inflammatory Bowel Disease.

Anja Bizjak1, Boris Gole1, Gregor Jezernik1

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Tofacitinib (TOFA) offers a convenient oral option for ulcerative colitis (UC), but response varies. This review identifies key biomarkers from multi-omics data to predict TOFA effectiveness and personalize treatment for better outcomes.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Genomics

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease impacting quality of life.
  • Biologics have improved UC management, but many patients lack response or lose efficacy.
  • Tofacitinib (TOFA), an oral Janus kinase (JAK) inhibitor, offers a novel therapeutic approach for UC.

Purpose of the Study:

  • To comprehensively review biomarkers predicting Tofacitinib (TOFA) response in ulcerative colitis (UC).
  • To explore multi-omics data for identifying novel predictors of TOFA efficacy.
  • To establish a foundation for precision medicine in TOFA treatment for UC.

Main Methods:

  • Literature review synthesizing multi-omics data (epigenomics, transcriptomics, proteomics, cellular profiling).
  • Analysis of emerging biomarkers associated with TOFA responsiveness in UC patients.
  • Examination of TOFA's dual mechanism involving immune modulation and epithelial barrier restoration.

Main Results:

  • Identified potential biomarkers including CpG methylation signatures (e.g., LRPAP1, FGFR2) and transcriptomic regulators (e.g., REG3A, CLDN3).
  • Highlighted the role of immune and epithelial cell shifts and the MATE1 transporter in predicting response.
  • Confirmed TOFA's dose-dependent efficacy and interpatient variability.

Conclusions:

  • Predictive biomarkers are crucial for optimizing Tofacitinib (TOFA) therapy in ulcerative colitis (UC).
  • Multi-omics approaches reveal promising markers for personalized TOFA treatment strategies.
  • This review provides a basis for precision medicine to enhance TOFA's clinical utility in UC.