Expression of HLA-G in inflammatory bowel disease provides a potential way to distinguish between ulcerative colitis and Crohn's disease.

In addition to being involved in nutrient uptake, the epithelial mucosa constitute the first line of defense against microbial pathogens. A direct consequence of this physiological function is a very complex network of immunological interactions that lead to a strong control of the mucosal immune balance. The dysfunction of immunological tolerance is likely to be a cause of inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD). HLA-G is a non-classical major histocompatibility complex (HLA) class I molecule, which is highly expressed by human cytotrophoblast cells. These cells play a role in immune tolerance by protecting trophoblasts from being killed by uterine NK cells. Because of the deregulation of immune system activity in IBD, as well as the immunoregulatory role of HLA-G, we have analyzed the expression of HLA-G in intestinal biopsies of patients with UC and CD. Our study shows that the differential expression of HLA-G provides a potential way to distinguish between UC and CD. Although the reason for this differential expression is unclear, it might involve a different mechanism of immune regulation. In addition, we demonstrate that in the lamina propria of the colon of patients with UC, IL-10 is strongly expressed. In conclusion, the presence of HLA-G on the surface of intestinal epithelial cell in patients with UC lends support to the notion that this molecule may serve as a regulator of mucosal immune responses to antigens of undefined origin. Thus, this different pattern of HLA-G expression may help to differentiate between the immunopathogenesis of CD and UC

Conocimiento de la fisiopatología de la Enfermedad Inflamatoria Intestinal a partir del estudio de su incidencia (Departamento de Salud 6 de Valencia)

La Enfermedad Inflamatoria Intestinal (Enfermedad de Crohn,EC; Colitis Ulcerosa,CU; Colitis inclasificable, CI) ha sufrido variaciones de incidencia, su estudio permite conocer los factores fisiopatológicos implicados y tratamientos específicos. Se ha realizado un estudio observacional retrospectivo de los casos diagnosticados de EII en el Departamento de Salud 6 de Valencia relacionando resultados con los obtenidos en España y otros países. La incidencia estandarizada a la población europea, ajustada a sexo y edad fue: 3.89(EC),6.635(CU) y de 2.845(CI). La incidencia de CU fue más elevada que la de EC, excepto en los más jóvenes, superior para CU y CI en hombres

Influència del tabac en la resposta a azatioprina en malaltia inflamatòria intestinal corticodepenent

Disposem d'evidència sobre la influència negativa del tabac en la malaltia de Crohn i el seu efecte positiu en la Colitis ulcerosa. Per altra banda, no s'ha avaluat una potencial interacció entre el tabaquisme i la resposta a determinats fàrmacs. En el present treball hem avaluat l'eficàcia de les tiopurines en la malaltia inflamatòria intestinal corticodepenent, en relació a l'existència d'hàbit tabàquic a l'inici del tractament i la seva influència en el seguiment dels pacients amb resposta inicial al fàrmac, valorant la necessitat de teràpies de rescat o de tractament quirúrgic durant la seva evolució segons l'hàbit tabàquic

Caracterización de biomarcadores en la recurrencia postquirúrgica de la enfermedad de Crohn : valor predictivo y/o implicación patogénica de los mismos

La recurrència postquirúrgica en els pacients amb malaltia de Crohn intervinguts és molt freqüent i, al seu torn, té implicacions terapèutiques importants. No s'han caracteritzat fins ara marcadors biològics que, pel seu valor predictiu, poguessin ser d'utilitat en el maneig postquirúrgic d'aquests pacients. En aquest estudi s'analitza el perfil evolutiu després de la cirurgia de diverses citocines (IL-2, IL-6, IL-10, IL1B, IFN-g i TNF-a), marcadors fecals (calprotectina) i paràmetres serològics (proteïna C reactiva, fibrinogen), per determinar la seva possible utilitat com a marcadors predictius de recurrència després de la cirurgia resectiva.La recurrencia postquirúrgica en los pacientes con enfermedad de Crohn intervenidos es muy frecuente y, a su vez, tiene implicaciones terapéuticas importantes. No se han caracterizado hasta la fecha marcadores biológicos que, por su valor predictivo, pudieran ser de utilidad en el manejo postquirúrgico de estos pacientes. En el presente estudio se analiza el perfil evolutivo tras la cirugía de diversas citoquinas (IL-2, IL-6, IL-10, IL1B, IFN-g y TNF-a), marcadores fecales (calprotectina) y parámetros serológicos (proteína C reactiva, fibrinógeno), para determinar su posible utilidad como marcadores predictivos de recurrencia tras la cirugía resectiva

Estudi de l'efecte del tractament amb Adalimumab sobre la microbiota associada a la mucosa intestinal en pacients amb malaltia de Crohn

La malaltia de Crohn és una malaltia inflamatòria intestinal en la qual s'ha observat que la densitat i la diversitat bacteriana difereixen dels subjectes sans. En els últims anys s'estan emprant tractaments biològics com els anti-TNFα (Adalimumab) de manera alternativa a tractaments ja existents. Els resultats obtinguts després de l'anàlisi de la composició bacteriana de la mucosa intestinal de pacients amb Malaltia de Crohn tractats amb Adalimumab, són esperançadors ja que apunten a una recuperació del patró normal a través de la recuperació d'espècies pròpies de persones sanes i la desaparició d'aquelles més prevalents en malalts de Crohn

Follow-up of atheroma burden with sequential whole body contrast enhanced MR angiography:a feasibility study

Assess the feasibility of whole body magnetic resonance angiography (WB-MRA) for monitoring global atheroma burden in a population with peripheral arterial disease (PAD). 50 consecutive patients with symptomatic PAD referred for clinically indicated MRA were recruited. Whole body MRA (WB-MRA) was performed at baseline, 6 months and 3 years. The vasculature was split into 31 anatomical arterial segments. Each segment was scored according to degree of luminal narrowing: 0 = normal, 1 = <50 %, 2 = 50–70 %, 3 = 71–99 %, 4 = vessel occlusion. The score from all assessable segments was summed, and then normalised to the number of assessable vessels. This normalised score was divided by four (the maximum vessel score) and multiplied by 100 to give a final standardised atheroma score (SAS) with a score of 0–100. Progression was assessed with repeat measure ANOVA. 36 patients were scanned at 0 and 6 months, with 26 patients scanned at the 3 years follow up. Only those who completed all three visits were included in the final analysis. Baseline atherosclerotic burden was high with a mean SAS of 15.7 ± 10.3. No significant progression was present at 6 months (mean SAS 16.4 ± 10.5, p = 0.67), however there was significant disease progression at 3 years (mean SAS 17.7 ± 11.5, p = 0.01). Those with atheroma progression at follow-up were less likely to be on statin therapy (79 vs 100 %, p = 0.04), and had significantly higher baseline SAS (17.6 ± 11.2 vs 10.7 ± 5.1, p = 0.043). Follow up of atheroma burden is possible with WB-MRA, which can successfully quantify and monitor atherosclerosis progression at 3 years follow-up

Macular and serum carotenoid concentrations in patients with malabsorption syndromes

The carotenoids lutein and zeaxanthin are believed to protect the human macula by absorbing blue light and quenching free radicals. Intestinal malabsorption syndromes such as celiac and Crohn’s disease are known to cause deficiencies of lipid-soluble nutrients. We hypothesized that subjects with nutrient malabsorption syndromes will demonstrate lower carotenoid levels in the macula and blood, and that these lower levels may correlate with early-onset maculopathy. Resonance Raman spectrographic (RRS) measurements of macular carotenoid levels were collected from subjects with and without a history of malabsorption syndromes. Carotenoids were extracted from serum and analyzed by high performance liquid chromatography (HPLC). Subjects with malabsorption (n = 22) had 37% lower levels of macular carotenoids on average versus controls (n = 25, P < 0.001). Malabsorption was not associated with decreased serum carotenoid levels. Convincing signs of early maculopathy were not observed. We conclude that intestinal malabsorption results in lower macular carotenoid levels

Management of Patients With Crohn's Disease and Ulcerative Colitis During the Coronavirus Disease-2019 Pandemic: Results of an International Meeting

The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) is the only global organization devoted to the study of and management of the inflammatory bowel diseases (IBDs), namely, Crohn?s disease and ulcerative colitis. Membership is composed of physician-scientists who have established expertise in these diseases. The organization hosts an annual meeting and a number of working groups addressing issues of the epidemiology of IBD, diet and nutrition, and the development and use of treatments for IBD. There are currently 89 members of IOIBD representing 26 different countries. The organization has taken particular interest in the coronavirus disease-2019 (COVID-19) pandemic and how it may affect the IBD patient population. This document summarizes the results of 2 recent virtual meetings of the group and subsequent expert guidance for patients and providers

Electrochemical sensing of membrane potential and enzyme function using gallium arsenide electrodes functionalized with supported membranes

We deposit phospholipid monolayers on highly doped p-GaAs electrodes that are precoated with methyl-mercaptobiphenyl monolayers and operate such a biofunctional electrolyte-insulator-semiconductor (EIS) setup as an analogue of a metal-oxide-semiconductor setup. Electrochemical impedance spectra measured over a wide frequency range demonstrate that the presence of a lipid monolayer remarkably slows down the diffusion of ions so that the membrane-functionalized GaAs can be subjected to electrochemical investigations for more than 3 days with no sign of degradation. The biofunctional EIS setup enables us to translate changes in the surface charge density Q and bias potentials Ubias into the change in the interface capacitance Cp. Since Cp is governed by the capacitance of semiconductor space charge region CSC, the linear relationships obtained for 1/Cp2 vs Q and 1/Cp2 vs Ubias suggests that Cp can be used to detect the surface charges with a high sensitivity (1 charge per 18 nm2). Furthermore, the kinetics of phospholipids degradation by phospholipase A2 can also be monitored by a significant decrease in diffusion coefficients through the membrane by a factor of 104. Thus, the operation of GaAs membrane composites established here allows for electrochemical sensing of surface potential and barrier capability of biological membranes in a quantitative manner