Bouts Of Inflammation Research Articles

Pathophysiology and Diagnosis of Ulcerative Colitis and Crohn Disease

Inflammatory bowel disease (IBD) encompasses both ulcerative colitis and Crohn disease, and is characterized by recurrent bouts of inflammation of the gastrointestinal tract. IBD affects approximately 4 million people worldwide, and rates are gradually increasing. This review covers the etiology, epidemiology, definition and pathophysiology, extraintestinal manifestations, and other disease-related complications of IBD. Figures show the distribution of ulcerative colitis and Crohn disease by location, several colonoscopic photographs of patients with ulcerative colitis as well as those with Crohn disease, computed tomography images of patients with Crohn disease, small bowel follow-through and fluoroscopic spot images of a patient with chronic structuring Crohn disease, and a computed tomographic scan showing extraenteric manifestations of Crohn disease. Tables list the differential diagnosis of ulcerative colitis, types of infectious colitis, complications of IBD, diagnostic criteria of toxic colitis, physical signs of Crohn disease, differences between Crohn disease and ulcerative colitis, and common extraintestinal manifestations of IBD. This review contains 11 highly rendered figures, 7 tables, and 63 references.

Pathophysiology and Diagnosis of Ulcerative Colitis and Crohn Disease

Inflammatory bowel disease (IBD) encompasses both ulcerative colitis and Crohn disease, and is characterized by recurrent bouts of inflammation of the gastrointestinal tract. IBD affects approximately 4 million people worldwide, and rates are gradually increasing. This review covers the etiology, epidemiology, definition and pathophysiology, extraintestinal manifestations, and other disease-related complications of IBD. Figures show the distribution of ulcerative colitis and Crohn disease by location, several colonoscopic photographs of patients with ulcerative colitis as well as those with Crohn disease, computed tomography images of patients with Crohn disease, small bowel follow-through and fluoroscopic spot images of a patient with chronic structuring Crohn disease, and a computed tomographic scan showing extraenteric manifestations of Crohn disease. Tables list the differential diagnosis of ulcerative colitis, types of infectious colitis, complications of IBD, diagnostic criteria of toxic colitis, physical signs of Crohn disease, differences between Crohn disease and ulcerative colitis, and common extraintestinal manifestations of IBD. This review contains 11 highly rendered figures, 7 tables, and 63 references.

Current perspectives on the assessment of vascular function and morphology in rheumatoid arthritis

„ „ Current versus cumulative inflammatory burden A possible explanation for the discrepant findings is the way the impact of inflammation on the vasculature is viewed. Although acute bouts of inflammation are important, the inflammatory burden over a period of time may be more crucial for the progression of vascular dysfunction [6]. Furthermore, the long-term metabolic effects of inflammation may lead to the development or deterioration of several classical CVD risk factors [7]. In RA, inflammation levels constantly fluctuate and the endothelium is exposed to varying inflammatory loads. Patients with greater periods of elevated systemic inflammation may develop more damage to the endothelium due to the higher cumulative inflammatory burden on the vasculature. Thus, characterizing the inf lammatory f luctuations over a period of time (cumulative inflammatory burden) may be a better predictor for vascular dysfunction in RA. Such an approach takes into account the inflammatory load during the course of the disease, with high inflammatory load likely to result in greater progression of atherosclerosis [6]. Indeed, studies have shown that when compared with current inflammatory levels, cumulative inflammation shows better association with vascular assessments characterizing different stages of atherosclerosis (i.e., vasodilatory function, arterial stiffness and carotid intimamedia thickness [cIMT]), reviewed in [3]. In line with this evidence it is tempting to speculate that continuous inflammatory insult may be more likely to lead to vascular impairments, but further studies that explore relationships between cumulative inflammation and vascular Rheumatoid arthritis (RA) is the commonest inf lammatory arthritis and associates with an increased risk for cardiovascular disease (CVD) [1]. Classical CVD risk factors along with systemic disease-related inflammation can both negatively impact upon the vasculature in RA [1]. During the last decade, there has been an abundance of studies that have examined peripheral vascular function and morphology in patients with RA. The advantage of these assessments is that they are noninvasive, relatively simple to perform and show, in the general population, good correlation with assessments of coronary endothelial function [2]. However, despite a number of advances in vascular rheumatology research, there are still several important issues that need to be addressed in future studies.

Relapsing Polychondritis: Systemic and Ocular Manifestations, Differential Diagnosis, Management, and Prognosis

Relapsing polychondritis (RP) is a rare systemic autoimmune disease characterized by episodic inflammation of cartilaginous tissues throughout the body. It is distinguished by recurrent bouts of inflammation, which lead to the permanent destruction of the involved structures. It can be a life-threatening, debilitating, and frightening disease and is often difficult to diagnose in its early stages. Ocular manifestations have been reported to occur in up to 65% of cases and include proptosis, eyelid edema, extraocular muscles palsy, episcleritis, scleritis, conjunctivitis, corneal infiltrate, peripheral ulcerative keratitis, corneal thinning or perforation, iridocyclitis, cataract, retinopathy, exudative retinal detachment, and optic neuritis. Corticosteroids remain the mainstay of treatment for RP; however, other treatment modalities include nonsteroidal anti-inflammatory drugs, colchicine, dapsone, and immunomodulatory drugs. This article reviews the literature and summarizes the epidemiology, pathogenesis, clinical features, treatment, and prognosis of the systemic and ocular manifestations of RP.

Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study

ObjectiveTo determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD.DesignPopulation-based cohort study.SettingComputerised records from...

Equine recurrent uveitis: The viewpoint from the USA

Equine recurrent uveitis (ERU) is a common disease in horses in the USA. There have been many advances in the treatment of ERU; however, frequent misdiagnosis of ERU occurs in cases of primary corneal or uveal disease. It is critical to remember that primary uveitis (i.e. one bout of inflammation) is a different disease to ERU, which is an immune mediated recurrent uveitis. Standard symptomatic anti-inflammatory therapy is effective to control most cases of ERU; however, some horses require advanced therapy, such as placement of drug delivery devices or removal of the vitreous, when they fail to respond to the standard therapy.

Visceral afferents: What role in post-inflammatory pain?

Several weeks to several months after a bout of inflammation or an infectious event in a visceral organ, while inflammation or infection has resolved, defective nociceptive functions are sometimes still present, characterized by chronic pain symptoms, visceral hyperalgesia and allodynia. Visceral afferents which convey nociceptive messages have been shown to be hyperexcitable in inflammatory states. Only recently, studies have addressed visceral afferent electrical properties and neuroplastic changes in post-inflammatory situations. This review tries to appraise in post-inflammatory hypersensitive states, the most recent advances in the knowledge of visceral afferent inputs, together with in vivo recordings of visceral hyperalgesia and allodynia.

Emerging roles for cyclooxygenase‐2 in gastrointestinal mucosal defense

The development of selective inhibitors of cyclooxygenase-2 (COX-2) was based on the concept that this enzyme played little, if any, role in modulating the ability of the gastrointestinal (GI) tract to resist and respond to injury. There is now overwhelming evidence that this is far from true. Indeed, COX-2 mediates several of the most important components of 'mucosal defense', contributes significantly to the resolution of GI inflammation and plays a crucial role in regulating ulcer healing. COX-2 also contributes to long-term changes in GI function after bouts of inflammation.

Persistent epithelial dysfunction and bacterial translocation after resolution of intestinal inflammation.

Epithelial secretion may play an important role in reducing bacterial colonization and translocation in intestine. If so, secretory dysfunction could result in increased susceptibility to infection and inflammation. We investigated whether long-term colonic secretory dysfunction occurs after a bout of colitis and if this is accompanied by an increase in bacterial colonization and translocation. Rats were studied 6 wk after induction of colitis with trinitrobenzene sulfonic acid when inflammation had completely resolved, and epithelial permeability was normal. Intestinal loops were stimulated with either Clostridium difficile toxin A or a phosphodiesterase inhibitor. In vitro, colonic tissue from previously sensitized rats was exposed to antigen (ovalbumin). Secretory responses to all three stimuli were suppressed in rats that had previously had colitis. These rats exhibited increased (16-fold) numbers of colonic aerobic bacteria and increased (>3-fold) bacterial translocation, similar to results in rats studied after resolution of enteritis. Postcolitis bacterial translocation was prevented by daily treatment with an inhibitor of inducible nitric oxide synthase. This study demonstrates that intestinal inflammation results in prolonged impairment of colonic epithelial secretion, which may contribute to increases in bacterial load and bacterial translocation. Epithelial dysfunction of this type could underlie an increased propensity for further bouts of inflammation, a hallmark of diseases such as inflammatory bowel disease.

Persistent mucin glycoprotein alterations in equine recurrent airway obstruction.

Horses with the episodic asthmalike condition of recurrent airway obstruction (RAO) have bouts of inflammation and bronchoconstriction associated with indoor housing. To assess the potential differences in airway secretions between RAO-affected and control horses, methods to quantify mucus secretions were developed and applied to bronchoalveolar lavage fluid. The relative difference in the amount of mucin glycoproteins between control and RAO-affected horses was assessed with a carbohydrate side chain-specific monoclonal antibody (4E4) in an enzyme-linked immunosorbent assay and by carbohydrate-specific enzyme-linked lectin assays. Significantly increased levels of 4E4-immunoreactive glycoprotein and the mucin-associated carbohydrates fucose (alpha-1,2 linkage) and N-acetylglucosamine were detected in RAO-affected horses in acute disease. RAO-affected horses in remission maintained significantly elevated levels of alpha-1,2-fucose and N-acetylglucosamine, whereas the 4E4-immunoreactive glycoprotein levels displayed a trend toward an increase over control levels. These results indicated that persistent changes in the quantity and/or quality of mucus glycoproteins occurred in the RAO-affected horses.

Induction of experimental allergic arthritis with outer surface proteins of borrelia burgdorferi

The arthritogenic potential of the cationic outer surface proteins (Osp) from Borrelia burgdorferi was tested in rats. Water-soluble Osps were prepared by butanol extraction and were administered by intraarticular injection. Tissue injury was assessed by scintigraphy and histology. A mild arthritis was seen in naive rats. Preimmunized animals had more severe, longer lasting bouts of inflammation. The Osps of Borrelia burgdorferi are potent arthritogens in rats. These immunodominant antigens may play a role in the development of Lyme arthritis in humans.

Effect of bran particle size on stool weight.

The increase in stool weight after feeding 20 g (dry weight) of bran daily was measured when this was of large particle size and after milling to small particle size. Twenty-eight investigations were carried out in 21 normal subjects. With coarse bran, stool weight was significantly greater than with the fine bran (mean 219.4 g/d coarse bran, 199-0 g/d fine bran: difference 20.4 g SE +/-6.4, P less than 00.1). The coarse bran also had a greater water-holding capacity (7.3 g water/g coarse bran, 3.9 water/g fine bran). Coarse bran was 2 1/2 times the volume of fine gran for a given weight and more fine bran will, therefore, be taken when bran is prescribed by the spoonful.