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  • 1
    Electronic Resource
    Electronic Resource
    Tioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 18 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Tioguanine (TG) is an antimetabolite which may be regarded as an alternative to azathioprine (AZA)/mercaptopurine (MP) in patients with inflammatory bowel diseases.Aims : To evaluate the tolerance and efficacy of TG in patients with Crohn's disease, intolerant or resistant to AZA/MP.Methods : An open prospective study was made on Crohn's disease patients treated with TG. Intolerance to AZA/MP was defined as a reaction occurring within 1 month after introduction of AZA/MP, including pancreatitis, abdominal pain, fever, arthralgia, myalgia, cutaneous rash, fatigue, alopecia, hepatitis and digestive intolerance. Resistance to AZA/MP was defined as the persistence of activity after at least 3 months of AZA/MP therapy.Results : Forty-nine Crohn's disease patients (36 women, 13 men; intolerance: n = 39; resistance: n= 10) were treated with TG (20 mg/day). Clinical pancreatitis did not recur under TG. Five patients (10%) had to stop TG due to intolerant reactions observed 13–21 days after TG was started. No haematological side-effects were observed under TG. The probability of clinical remission without corticosteroids or infliximab at 6 and 12 months was 46% and 79%, respectively, in the 40 patients with active disease at baseline. The probability of clinical relapse during maintenance TG therapy at 6 and 12 months was 29% and 53%, respectively, in the 28 patients in remission at baseline or who had achieved remission on TG.Conclusions : TG is a possible alternative treatment in Crohn's disease patients, intolerant (especially for pancreatitis) or resistant to AZA/MP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01683.x
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  • 2
    Electronic Resource
    Electronic Resource
    Anti-〈fr〉Saccharomyces〈/fr〉 cerevisiae mannan antibodies in inflammatory bowel disease: comparison of different assays and correlation with clinical features (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 20 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Anti-Saccharomyces cerevisiae mannan antibodies have been proposed as a new serological marker associated with Crohn's disease. However, their clinical value is still unclear; furthermore, a standardization of anti-S. cerevisiae mannan measurements is lacking.Aim : In this study, we aimed to assess the correlation between anti-S. cerevisiae mannan detection and specific clinical features in Crohn's disease and ulcerative colitis. Moreover, we tested the concordance of four different anti-S. cerevisiae mannan assays.Materials and methods : Serum samples from 196 patients with Crohn's disease, 197 patients with ulcerative colitis and 100 unrelated healthy controls were tested for anti-S. cerevisiae mannan with a standard enzyme-linked immunosorbent assay method (Lille) by one of the authors (VP). Subsequently, 60 randomly selected serum samples (27 Crohn's disease, 28 ulcerative colitis and five healthy controls) were tested for anti-S. cerevisiae mannan with three different commercial kits.Results : With the Lille assay, anti-S. cerevisiae mannan were detected in 100 of 196 patients with Crohn's disease (51%; P 〈 0.0001 vs. controls), 32 of 197 patients with ulcerative colitis (16%; P 〈 0.02 vs. controls), and six of 100 controls (6%). No correlation between presence of anti-S. cerevisiae mannan and specific clinical features was found in both ulcerative colitis and Crohn's disease patients. The percentages of anti-S. cerevisiae mannan detected with four different assays ranged from 28 (Bouty) up to 43% (Inova), but these differences did not reach statistical significance. The concordance rate of anti-S. cerevisiae mannan detection in the four assays was very low (11 concordant results of 60 samples, 18.3%) (k = 0.15). No improvement of the concordance rate wasobtained by modifying the suggested cut-off values (k = 0.20).Conclusion : In this study, we confirm that anti-S. cerevisiae mannan are significantly more frequent in Crohn's disease patients compared with ulcerative colitis patients (P 〈 0.0001) and controls. However, no correlation with clinical features was found in both ulcerative colitis and Crohn's disease. The low prevalence of anti-S. cerevisiae mannan, at least in our population, and the low concordance rate between different assays, makes the clinical role of this marker questionable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.02258.x
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  • 3
    Electronic Resource
    Electronic Resource
    Inhibitory effect of probiotic Escherichia coli strain Nissle 1917 on adhesion to and invasion of intestinal epithelial cells by adherent–invasive E. coli strains isolated from patients with Crohn's disease (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 18 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Pathogenic adherent–invasive Escherichia coli have been isolated from ileal lesions of Crohn's disease.Aim : To investigate the non-pathogenic E. coli strain Nissle 1917 (Mutaflor) as possible maintenance therapy in inflammatory bowel disease by testing its ability to prevent adherent–invasive E. coli strains from adhering to and invading human intestinal epithelial cells in vitro.Methods : Bacterial adhesion to and invasion of intestinal epithelial cells (Intestine-407) were assessed by counting the colony-forming units. The inhibitory effect of E. coli Nissle 1917 was determined after co-incubation with adherent–invasive E. coli strains or after pre-incubation of the intestinal epithelial cells with this probiotic strain prior to infection with adherent–invasive E. coli strains.Results : Strain Nissle 1917 exhibited dose- and time-dependent adherence to intestinal epithelial cells and inhibited the adhesion and invasion of various adherent–invasive E. coli strains. In co-infection experiments, the inhibitory effect on adherent–invasive E. coli adhesion reached 78–99.9%. Pre-incubation of intestinal epithelial cells with strain Nissle 1917 reduced adherent–invasive E. coli adhesion by 97.2–99.9%. The inhibitory effect on adherent–invasive E. coli invasion paralleled that on adhesion.Conclusion : As strong and significant inhibitory effects on adherent–invasive E. coli adhesion and invasion were observed in co-infection and pre-infection experiments, E. coli Nissle 1917 could be efficient for preventive or curative probiotic therapy in patients with Crohn's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01638.x
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  • 4
    Electronic Resource
    Electronic Resource
    Treatment of severe Crohn's disease with anti-CD4 monoclonal antibody (1996)
    Oxford BSL : Blackwell Science
    Alimentary pharmacology & therapeutics 10 (1996), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Monoclonal CD4 antibodies have been proposed as a new immunosuppressant drug in the treatment of inflammatory bowel disease. We report our experience of treatment with a monoclonal anti-CD4 (B-F5) antibody in severe refractory Crohn's disease. Methods: Twelve patients with severe refractory Crohn's disease were treated in an open clinical trial. B-F5 was given intravenously at a dose of 0.5 mg.day/kg for 7 consecutive days (patients 1–8). For patients 9–12, B-F5 was given at a dose of 0.5 mg.day/kg on the first day (day 0) and of 1 mg.day/kg on days 1–6. Follow-up examinations were carried out at days 8, 15, 22 and 30. Endoscopic evaluation was performed on days 0 and 30 in eight of 12 patients. Results: Immediately after the first infusion, one patient had dyspnoea and tachycardia requiring cessation of the treatment. Among the 11 patients who received the complete course of treatment, two had prolonged clinical improvement and two had partial clinical improvement. Significant endoscopic improvement was observed in only one patient. No sustained depletion of CD4+ cells could be observed. Conclusion: In this uncontrolled open trial, monoclonal anti-CD4 B-F5 antibody was not successful in severe Crohn's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1996.59201000.x
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  • 5
    Electronic Resource
    Electronic Resource
    Association between polymorphism in IgG Fc receptor IIIa coding gene and biological response to infliximab in Crohn's disease (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 19 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim : To test the hypothesis of an association between polymorphism in FCGR3A (the gene coding for FcγRIIIa, which is expressed on macrophages and natural killer cells, is involved in antibody-dependent cell-mediated cytotoxicity and has recently been associated with a positive response to rituximab, a recombinant immunoglobulin G1 antibody used in non-Hodgkin's lymphomas) and response to infliximab in Crohn's disease.Methods : FCGR3A-158 polymorphism was determined using an allele-specific polymerase chain reaction assay in 200 Crohn's disease patients who had received infliximab for either refractory luminal (n = 142) or fistulizing (n = 58) Crohn's disease. Clinical and biological responses (according to C-reactive protein levels) were assessed in 200 and 145 patients, respectively.Results : There were 82.9% clinical responders in V/V patients vs. 72.7% in V/F and F/F patients (N.S.). Globally, the decrease in C-reactive protein was significantly higher in V/V patients than in F carriers (P = 0.0078). A biological response was observed in 100% of V/V patients, compared with 69.8% of F carriers (P = 0.0002; relative risk, 1.43; 95% confidence interval, 1.27–1.61). In the sub-group of patients with elevated C-reactive protein before treatment, the multivariate analysis selected the use of immunosuppressive drugs and FCGR3A genotype as independent factors influencing the clinical response to infliximab (P = 0.003).Conclusion : Crohn's disease patients with FCGR3A-158 V/V genotype have a better biological and, possibly, clinical response to infliximab.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.01871.x
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  • 6
    Electronic Resource
    Electronic Resource
    Impaired contractile response of mesenteric arteries in Crohn’s disease (2000)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 14 (2000), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Crohn’s disease is associated with vascular injury and dysregulation of the intestinal immune system which together can provide disturbance of mesenteric circulation functional properties.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate the vascular reactivity of mesenteric arteries from patients with Crohn’s disease.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Phenylephrine-induced contractions were assessed from 10 patients with Crohn’s disease and 8 control organ donors. NG-nitro-L-arginine-methyl-ester (L-NAME) was used to test the presence of inducible NO synthase. Endothelium dependent and independent relaxation was assessed using acetylcholine, bradykinin, calcium ionophore A23187 and sodium nitroprusside.〈section xml:id="abs1-4"〉〈title type="main"〉Results:The contractile response to phenylephrine was significantly decreased in arteries without endothelium from patients with Crohn’s disease. Exposure to the NO synthase inhibitor L-NAME restored the contractile response to phenylephrine. Relaxation remained unaltered in both groups.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion:These data provide direct evidence for fading of contraction caused by phenylephrine in Crohn’s disease. The restored mesenteric artery tone by a specific NO synthase inhibitor suggests that an increased production for NO in vascular smooth muscle might be responsible of this altered vascular reactivity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2000.00838.x
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  • 7
    Electronic Resource
    Electronic Resource
    Cholestasis and pneumonitis induced by gold therapy (1989)
    Springer
    Clinical rheumatology 8 (1989), S. 538-540 
    Details
    ISSN: 1434-9949
    Keywords: Gold Salt Therapy ; Adverse Effects ; Lymphocytes Alveolitis ; Cholestasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors describe the association of gold saltinduced cholestasis and lymphocytic alveolitis proved by liver biopsy and bronchoalveolar lavage. To our knowledge this is the third case report on the combination of liver disease and pulmonary infiltration induced by gold compounds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02032111
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  • 8
    Electronic Resource
    Electronic Resource
    Fecal β-D-Galactosidase Production and Bifidobacteria Are Decreased in Crohn's Disease (1997)
    Springer
    Digestive diseases and sciences 42 (1997), S. 817-822 
    Details
    ISSN: 1573-2568
    Keywords: CROHN'S DISEASE ; BIFIDOBACTERIA ; β-D-GALACTOSIDASE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Digestive bacterial microflora play a major rolein the pathogenesis of Crohn's disease (CD). Bacterialenzyme activities, especially β-D-galactosidase,are decreased in fecal extracts from CD patients. We hypothesized that an alteration of thecolonic flora might be responsible for this decrease.Indeed, we demonstrate that β-D-galactosidaseproduction in supernates of anaerobic cultures wassignificantly (P 〈 0.01) reduced in feces from patientswith active Crohn's disease (N = 7), when compared tohealthy controls (N = 8). Therefore using X-gal andselective media, we enumerated bacteria able to releaseβ-D-galactosidase in feces from patients with active (N = 16) orquiescent disease (N = 5) and healthy controls (N = 14).Bifidobacteria numbers were significantly reduced inpatients (P 〈 0.01 for active; P 〈 0.02 forquiescent disease) whereas Bacteroides and Lactobacilli countsremained unchanged. β-D-Galactosidase activity andBifidobacteria counts were significantly correlated (P〈 0.03). Bifidobacteria are regarded as beneficial for the host. The reduction in Bifidobacteriais responsible for decreased β-D-galactosidaseactivity. Thus oral administration of prebiotics thatpromote their growth might have potential therapeutic interest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018876400528
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  • 9
    Electronic Resource
    Electronic Resource
    Bacterial enzymes used for colon-specific drug delivery are decreased in active Crohn's disease (1995)
    Springer
    Digestive diseases and sciences 40 (1995), S. 2641-2646 
    Details
    ISSN: 1573-2568
    Keywords: Crohn's disease ; colonic metabolism ; fecal glycosidases ; fecal azoreductase ; drug release
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Enzymes produced by colonic microflora have been proposed for triggering local delivery of antiinflammatory azo-bond drugs and prodrugs to the colon. This approach could be advantageous in steroid treatment of inflammatory bowel diseases, thus sparing steroids' side effects. We recently demonstrated that the metabolic activity of digestive flora, assessed on the activity of fecal glycosidases, was decreased in patients with active Crohn's disease. In the present study, the azoreductase activity in feces of 14 patients with active Crohn's disease was decreased (11.39±7.93 mU/g F) as compared with 12 healthy subjects (51.13±21.39 mU/g F). β-d-Glucosidase and β-d-glucuronidase activities in fecal homogenates incubated under anaerobic conditions were also decreased in patients. These data bring into question the therapeutic usefulness for those patients of azo-bond drugs and glycoside prodrugs. They could explain the therapeutic failure of some of those drugs in active ileocolic and colic Crohn's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02220454
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  • 10
    Electronic Resource
    Electronic Resource
    Immunoglobulin G Subclass Distribution of Anti-Endothelial Cell Antibodies (AECA) in Patients with Ulcerative Colitis or Crohn's Disease (1997)
    Springer
    Digestive diseases and sciences 42 (1997), S. 2350-2355 
    Details
    ISSN: 1573-2568
    Keywords: ANTI-ENDOTHELIAL CELL ANTIBODIES ; IMMUNOGLOBULIN SUBCLASSES ; CROHN'S DISEASE ; ULCERATIVE COLITIS ; INFLAMMATORY BOWEL DISEASE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Anti-endothelial cell antibodies have beendescribed in sera from patients with inflammatory boweldisease. The aim of this study was to determine, byELISA, the IgG subclass distribution of anti-endothelial cell antibodies, in patients with ulcerativecolitis (N = 28) or Crohn's disease (N = 82) as comparedwith blood donors (N = 95). Thirty-six percent ofulcerative colitis and 23% of Crohn's disease patients were positive for at least one of the IgGanti-endothelial cell subclasses. Interestingly, thepattern of IgG anti-endothelial cell subclass observedin the two inflammatory bowel diseases differs. InCrohn's disease, the IgG1 anti-endothelial cellantibody level was significantly increased (P 〈 0.05)while IgG2 and IgG4 anti-endothelial cell antibodylevels were decreased (P 〈 0.0001 and P 〈 0.01, respectively) as compared to ulcerative colitispatients. The immunoglobulin G3anti-endothelial cell antibody level was decreased inboth ulcerative colitis and Crohn's disease patients ascompared to healthy blood donors. No relationship wasdetected between disease activity of ulcerative colitisor Crohn's disease patients and anti-endothelial cellIgG subclasses. Finally, the disparity of IgGanti-endothelial cell subclass distribution in these twoinflammatory bowel diseases suggests that the ability toactivate effector mechanisms is not identical, andhence, deals with the concept of distinctivepathogenetic mechanisms in these two diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018839306367
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