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

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

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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
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Inflammatory Bowel Disease II: Crohn's Disease01:30

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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
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ガルカネズマブは炎症性サイトカインを調節できるか?単一施設での探索的研究

Giulia Ceccardi1, Renata Rao2,3, Francesca Schiano di Cola3

  • 1Neurology Unit, Ospedale Maggiore di Cremona, ASST-Cremona, 26100, Cremona, Italy. giulia.ceccardi@outlook.it.

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PubMed
まとめ

エピソード型片頭痛患者は、慢性片頭痛および健常者と比較して特定のサイトカインレベルが高いことを示した。ガルカネズマブ治療はこれらのサイトカインレベルを一時的に低下させ、CGRPが片頭痛の炎症に影響を与えることを示唆している。

キーワード:
抗CGRPモノクローナル抗体サイトカイン炎症片頭痛

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科学分野:

  • 神経学
  • 免疫学
  • 薬理学

背景:

  • 片頭痛は、複雑な病態生理を持つ障害である。
  • カルシトニン遺伝子関連ペプチド(CGRP)が関与しているが、サイトカインを含む神経炎症などの代替メカニズムが示唆されている。
  • 異なるサイトカインプロファイルが片頭痛のサブタイプを区別し、治療反応に影響を与える可能性がある。

研究 の 目的:

  • エピソード型片頭痛(EM)、慢性片頭痛(CM)、および健常対照(HC)の血漿サイトカインプロファイルを比較すること。
  • EM患者におけるサイトカインレベルに対するガルカネズマブの効果を調査すること。

主な方法:

  • 17人のEM、18人のCM患者、および17人のHCを対象とした前向きパイロットスタディ。
  • 切間期に多重免疫測定法を用いて血漿サイトカインレベル(IFN-γ、IL-1β、IL-10、IL-6、TNF-α)を測定。
  • ガルカネズマブを投与されたEM患者は、ベースライン、Cmax(5日)、および薬物半減期(27日)でサンプルを採取した。

主要な成果:

  • EM患者は、CMおよびHCと比較して、IFN-γ、IL-1β、IL-6、IL-10の切間期レベルが高いことを示した。
  • ガルカネズマブ治療は、CmaxでIFN-γ、IL-1β、IL-10、TNF-αの有意な減少をもたらしたが、IL-6はそうではなかった。
  • サイトカインレベルは、ガルカネズマブ療法の最初の1か月間に一時的な減少を示した。

結論:

  • 異なるサイトカインプロファイルは、EMおよびCMに関連している。
  • ガルカネズマブ治療は、炎症促進性および炎症抑制性の両方のサイトカインを一時的に減少させる。
  • 本研究結果は、片頭痛の病態生理における炎症経路の調節におけるCGRPの役割を支持する。