Inflammatory Bowel Disease Location Research Articles

A Programmable Oral Nanomotor Microcapsule for the Treatment of Inflammatory Bowel Disease

AbstractGiven the unique anatomy and location of inflammatory bowel disease (IBD), oral pharmacological treatment is the mainstay for managing IBD because of its convenience and direct accessibility to the gastrointestinal tract. However, efficient delivery systems must be designed to navigate the harsh gastrointestinal environment during application. Here, an innovative oral drug delivery system was proposed using nanomotor (NM)‐loaded soluble microcapsules for treating IBD. MnO2‐Au‐mSiO2 NMs incorporate partially encapsulated MnO2 antennas that convert reactive oxygen species into oxygen, autonomously propelling the NMs. Astaxanthin (AST), known for its anti‐inflammatory properties, is loaded into the mesoporous silica (mSiO2) of NMs (AST@NMs). AST effectively reduces inflammation and shifts macrophages from a proinflammatory (M1) phenotype to an anti‐inflammatory (M2) phenotype. To protect the nanomotors from harsh digestive conditions and achieve intestinal‐responsive release, using photocurable 3D printing, we fabricated enteric‐coated oral microcapsules (MCs). Additionally, to prevent leakage of AST@NMs, a calcium alginate shell was cured in situ on the surface of the microcapsules (AST@NMs@MCs). In vitro and in vivo, AST@NMs@MCs effectively reduced inflammation, repaired the intestinal barrier, and modulated the gut microbiota. These findings underscore the protective effects of the microcapsules on AST@NM, highlighting their potential as a promising strategy for treating colitis.

Inflammatory bowel disease in Icelandic children 1951–2010. Population-based study involving one nation over six decades

Aim and background. We describe the changes in incidence and disease location of inflammatory bowel disease (IBD) in children in one country over six decades. Iceland is an island with centralized health information. Children with IBD are cared for in only two hospitals. Iceland is therefore well suited for nationwide epidemiologic studies. Material and methods. All IBD patients 16 years and younger diagnosed in Iceland from 1950–2010 were included. Patients were identified retrospectively from 1950–1989, and propectively from 1990–2010, by reviewing pathology and charts for all patients diagnosed with IBD. Criteria for the diagnosis of ulcerative colitis (UC) were history of blood in stools for >3 weeks, characteristic endoscopic appearance of continuous inflammation of the colon, and histologic appearance of acute and chronic inflammation of the colon without granulomata. Criteria of Crohn's disease (CD) were history of abdominal pain, blood in stools, and endoscopic, radiologic, and histologic features of CD. Results. One hundred and ten children were diagnosed with IBD, 61 with UC, 44 with CD, and 5 with indeterminate disease. The median age was 13.7 ± 2.6, with sex distribution varying from decade to decade. From 1980 until 2000, there was a dramatic increase in the incidence of IBD from 1.2 per 100,000 children <16 years of age to 5.6 per 100,000. However, in the past decade, the incidence has plateaued. Conclusion. In this population-based pediatric study, we report an increase in the incidence of IBD from 1950–2000. Incidence in Icelandic children is lower than in published studies from other Northern European countries.

Pyoderma gangraenosum

To describe current progress in understanding pyoderma gangraenosum, illustrate clinical observations and discuss therapeutic interventions. The proline-rich, glutamic acid-rich, serine-rich and threonine-rich (PEST) family of protein tyrosine phosphatases is a critical regulator of adhesion and migration. PSTPIP1 is a cytoskeleton-associated adaptor protein that links PEST-type phosphatases to their substrates. This pathway seems to be involved in diseases related to pyoderma gangraenosum such as chronic inflammatory bowel disease and aseptic abscesses syndrome. Pyoderma gangraenosum is one of the most common extra-intestinal manifestations of chronic inflammatory bowel disease. In multivariate analyses, pyoderma gangraenosum was significantly and independently associated with black African origin, familial history of ulcerative colitis, uninterrupted pancolitis as the initial location of inflammatory bowel disease, permanent stoma, eye involvement and erythema nodosum. The treatment of choice for idiopathic pyoderma gangraenosum is systemic corticosteroids but cyclosporine A, mycophenolate mofetil and tumour necrosis factor-alpha inhibitors have been successful to control pyoderma gangraenosum as second line or adjuvant options. In addition, small studies have been published with successful therapeutic intervention using alefacept, visilizumab or anakinra but controlled trials are warranted. Although systemic immunosuppressants remain the choice therapy for most cases of pyoderma gangraenosum, a local approach should be considered in localized disease. Recently, topical tacrolimus has successfully been used as an off-label drug in localized disease. By a better understanding of the underlying pathology and recent drug developments patients with pyoderma gangraenosum will benefit. For several new drugs, however, controlled trials are warranted.

Ultrasound and Inflammatory Bowel Disease

Transabdominal bowel sonography is a fast, efficient, and cheap way of examining the intestines. It is also virtually hazard-free and well accepted by patients. During the last 20 years, it has been established as a procedure for detecting bowel disease early in the diagnostic workup. Although rather unspecific, the method is sensitive for detection of bowel disease and can be applied to find the extent and location of inflammatory bowel disease. In patients with known ulcerative colitis and Crohn disease, it can also be used for follow-up because it is easily repeatable and radiation-free. Because it can be applied to find both intraluminal and peri-intestinal pathological features, it is a particularly valuable tool for the detection of complications of Crohn disease as stenosis, fistulas, and abscesses. Neither B-mode nor Doppler techniques have been proven obviously useful in categorizing disease activity, but new techniques using intravenous contrast might come closer to solving this question. Finally, recent longitudinal studies using transabdominal bowel sonography show that it can also give important prognostic information and be used for monitoring the effect of therapy.

Tonsillectomy and inflammatory bowel disease location

Tonsillectomy and inflammatory bowel disease location

Tonsillectomy and inflammatory bowel disease location.

Epidemiological studies have found an increased frequency of childhood infections and tonsillectomies in patients with inflammatory bowel disease (IBD). The aim of our study was to test whether particular clinical patterns of IBD could be associated with previous tonsillectomy. Two hundred and twenty consecutive IBD patients (100 with Crohn's disease (CD) and 120 with ulcerative colitis (UC)) were prospectively assessed and classified into groups according to disease location. In those with a positive history of tonsillectomy, an ear, nose and throat (ENT) examination was carried out to confirm the diagnosis. Eighty-two IBD patients (37%) underwent tonsillectomy in childhood: 47 out of 100 CD patients (47%), and 35 out of 120 UC patients (29%). Disease location in CD patients affected the ileum in 28, and 21 of them were tonsillectomized (tonsillectomy rate of 75%). Thirty-six patients had an ileocolonic location, and 14 of them had had a tonsillectomy (39%). With disease confined to the colon, only 9 out of 29 patients (31%) had undergone previous tonsillectomy. The higher prevalence of tonsillectomy in patients with CD ileitis was statistically significant (P = 0.0034). No significant differences between groups of UC patients according to the extent of the disease were found. The ileum is the most prevalent location of disease in CD patients with previous tonsillectomy.