Journal of Gastrointestinal & Digestive System最新文献

英文中文

Inflammatory Bowel Disease Associated Colorectal Neoplasia. 炎症性肠病相关结直肠肿瘤。

Journal of Gastrointestinal & Digestive System

Pub Date : 2012-01-23 DOI: 10.4172/2161-069X.S8-002

Michelle Vu, Jyh-Yau Chang, Jeremy Chen, David Q Shih

Patients with ulcerative colitis (UC) or Crohn's colitis have a greater risk for developing colorectal cancer (CRC). Many studies have described the evolving epidemiology and risk factors for CRC in patients with inflammatory bowel disease (IBD). Recent evidence indicates that the incidence has been decreasing with the advancement of medical and surgical therapies, and surveillance has emerged as the foundation of prevention. Chemoprophylaxis is another area of research; however, given the limited efficacy of these agents, they are only being used in conjunction with endoscopic surveillance. Our ability to formulate effective strategies for the prevention of this dreaded complication expands as more is discovered of the molecular events underlying IBD carcinogenesis. Management strategies are constantly updated as new evidence and endoscopic techniques emerge. In this paper, we review the literature regarding epidemiology, pathogenesis, risk factors and chemoprophylaxis as well as the latest consensus guidelines for management of dysplasia and neoplasia in IBD patients.

溃疡性结肠炎(UC)或克罗恩结肠炎患者患结直肠癌(CRC)的风险更高。许多研究描述了炎症性肠病(IBD)患者CRC的流行病学演变和危险因素。最近的证据表明，随着医学和外科治疗的进步，发病率一直在下降，监测已成为预防的基础。化学预防是另一个研究领域;然而，鉴于这些药物的疗效有限，它们只能与内窥镜监测结合使用。随着对IBD致癌性的分子事件的发现越来越多，我们制定有效策略预防这一可怕并发症的能力也在不断增强。随着新的证据和内窥镜技术的出现，管理策略不断更新。本文就IBD的流行病学、发病机制、危险因素、化学预防等方面的文献进行综述，并对IBD患者发育不良和肿瘤的最新共识治疗指南进行综述。

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引用次数: 2

Markers of Inflammation and Lineage on Exfoliated Colonic Cells In Pediatric Inflammatory Bowel Disease. 儿童炎症性肠病中脱落结肠细胞的炎症标志物和谱系。

Journal of Gastrointestinal & Digestive System

Pub Date : 2011-12-16 DOI: 10.4172/2161-069X.S8-001

Padmanabhan P Nair, Alka Kamra, George Kessie, Shilpa Kalavapudi, June-Home Chen, Robert Shores, Lisa Madairos, Alessio Fasano, Prasanna Nair

Objectives: The diagnosis (endoscopy, and biopsy) and continued clinical management of Inflammatory Bowel Disease (IBD), remain highly invasive, expensive, and inconvenient for the pediatric patient. The objective of this study was to see if colonocytes obtained from stools of subjects with IBD and normal controls would demonstrate higher levels of inflammatory markers (Cox 2 in CD45+ and CD45- cells) and if the inflammatory process and treatment effects would be reflected in an altered cytokine expression in the subjects compared to controls.

Setting: Outpatient hospital based pediatric gastroenterology clinic.

Methods and main outcome measures: Stool samples (~ 1 gm), were obtained from 18 children between the ages of 4 and 18 diagnosed with IBD, and from a normal first degree relative. Colonocytes were isolated using the Somatic Cell Sampling Recovery (SCSR) system and assessed for the expression of COX-2, CD-45, IgA, IgG, IL6, IL18, TGF β, TNF, and IL16β using flow cytometry. In addition, levels of COX-2 and cytokeratin 19 transcripts were measured by microwell plate hybridization assay.

Results: Expression of COX-2 and co-expression of IgA and IgG were significantly higher in the IBD cases compared to the controls. In ulcerative colitis, the expression of COX-2 and co-expression of COX-2 and CD45 were greater than that in patients with Crohn's disease. In contrast, cells expressing IgA and IgG were higher in Crohn's. Subjects on immunosuppressants and/or anti-inflammatory medications, expressed significantly lower levels of COX-2 and IL-18 compared to those who were not on treatment.

Conclusions: This study indicates that the use of disease markers on exfoliated colonic cells can be used for non-invasive assessment of disease status, for follow-up of response to treatment and for forecasting flare-up of disease before its symptomatic manifestations.

目的:炎症性肠病(IBD)的诊断(内镜检查和活检)和持续的临床治疗对儿科患者来说仍然是高度侵入性的，昂贵的，不方便的。本研究的目的是观察从IBD患者和正常对照组的粪便中获得的结肠炎细胞是否表现出更高水平的炎症标志物(CD45+和CD45-细胞中的Cox 2)，以及与对照组相比，炎症过程和治疗效果是否会反映在细胞因子表达的改变上。环境:以医院为基础的儿科胃肠病学门诊。方法和主要结果测量:从18名4 - 18岁诊断为IBD的儿童和正常的一级亲属中获得粪便样本(~ 1 gm)。使用体细胞取样回收(SCSR)系统分离结肠细胞，并使用流式细胞术检测COX-2、CD-45、IgA、IgG、IL6、IL18、TGF β、TNF和IL16β的表达。此外，用微孔板杂交法测定COX-2和细胞角蛋白19转录本的水平。结果:IBD患者COX-2的表达及IgA、IgG的共表达明显高于对照组。溃疡性结肠炎患者COX-2的表达及COX-2与CD45的共表达均高于克罗恩病患者。相反，克罗恩病中表达IgA和IgG的细胞增多。与未接受治疗的受试者相比，接受免疫抑制剂和/或抗炎药物治疗的受试者表达的COX-2和IL-18水平显著降低。结论:本研究表明，利用脱落的结肠细胞上的疾病标志物可用于无创评估疾病状态，随访治疗反应，并在症状出现之前预测疾病的爆发。

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引用次数: 10

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