Intestinal Research

Original Articles

IBD

Leucine-rich alpha-2 glycoprotein is useful in predicting clinical relapse in patients with Crohn’s disease during biological remission: Naohiro Nakamura, Yusuke Honzawa, Yuka Ito, Yasuki Sano, Naoto Yagi, Sanshiro Kobayashi, Mamiko Aoi, Takashi Tomiyama, Tomomitsu Tahara, Norimasa Fukata, Toshiro Fukui, Makoto Naganuma; Intest Res 2025;23(2):170-181. Published online August 19, 2024; DOI: https://doi.org/10.5217/ir.2024.00042

Abstract PDF PubReader ePub: Background/Aims
Serum leucine-rich alpha-2 glycoprotein (LRG) is a potential biomarker of Crohn’s disease (CD). This study aimed to evaluate the usefulness of LRG in predicting clinical relapse in patients in remission with CD.
Methods
This retrospective observational study assessed the relationships among patient-reported outcome (PRO2), LRG, and other blood markers. The influence of LRG on clinical relapse was assessed in patients in remission with CD.
Results
Data of 94 patients tested for LRG between January 2021 and May 2023 were collected. LRG level did not correlate with PRO2 score (ρ = 0.06); however, it strongly correlated with C-reactive protein (CRP) level (r=0.79) and serum albumin level (r=–0.70). Among 69 patients in clinical remission, relapse occurred in 22 patients (31.9%). In the context of predicting relapse, LRG showed the highest area under the curve, followed by CRP level, platelet count, and albumin level. Multivariate analysis revealed that only LRG (P= 0.02) was an independent factor for predicting clinical remission. The cumulative non-relapse rate was significantly higher in patients with LRG < 13.8 μg/mL than in patients in remission with LRG ≥ 13.8 μg/mL and normal CRP level (P= 0.002) or normal albumin level (P= 0.001). Cumulative non-relapse rate was also higher in patients with LRG < 13.8 μg/mL compared to those with LRG ≥ 13.8 μg/mL in patients with L3 or B2+B3 of Montreal calcification.
Conclusions
LRG is useful in predicting clinical relapse in patients with CD during biological remission. LRG is a useful biomarker for predicting prognosis, even in patients with intestinal stenosis, or previous/present fistulas.

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Inflammatory bowel diseases

5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis: Shinta Mizuno, Keiko Ono, Yohei Mikami, Makoto Naganuma, Tomohiro Fukuda, Kazuhiro Minami, Tatsuhiro Masaoka, Soichiro Terada, Takeshi Yoshida, Keiichiro Saigusa, Norimichi Hirahara, Hiroaki Miyata, Wataru Suda, Masahira Hattori, Takanori Kanai; Intest Res 2020;18(1):69-78. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.00084

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.
Methods
We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.
Results
Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).
Conclusions
In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.

Citations

Citations to this article as recorded by

Gut Microbiome Dysbiosis and Inflammatory Bowel Disease Complement Each Other
Huan Zhang, Jingrong Xiang, Jie Feng, Mengting Zhang, Qinhua Xi
Digestive Diseases.2025; 43(3): 345. CrossRef
Drug-induced Interstitial Nephritis in a Patient with Ulcerative Colitis Treated with 5-Aminosalicylic Acid
Daichi Hayashi, Tsutomu Nishida, Naoto Osugi, Yasuo Kusunoki, Satoru Okabe, Yoshifumi Fujii, Dai Nakamatsu, Kengo Matsumoto, Masashi Yamamoto, Koji Fukui
Internal Medicine.2024; 63(8): 1081. CrossRef
The impact of 5-aminosalicylates on the efficacy of mesenchymal stem cell therapy in a murine model of ulcerative colitis
Huanhuan Chen, Huimin Wang, XiaoJing Xu, Ya'nan Hu, Jing Su, Dongdong Li, Zimu Li, Shixiang Feng, Jinming Liu, Huanxiang Zhang, Xiaoyan Wang
International Immunopharmacology.2024; 134: 112255. CrossRef
Characteristics of Mucosa-Associated Microbiota in Ulcerative Colitis Patients with 5-Aminosalicylic Acid Intolerance
Hiroshi Matsumoto, Momoyo Sasahira, Tei Tei Go, Shogen Yo, Takehiro Ninomiya, Motoyasu Osawa, Osamu Handa, Eiji Umegami, Ryo Inoue, Akiko Shiotani
Biomedicines.2024; 12(9): 2125. CrossRef
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Jiayi Li, Meng Shao, Hao Liu, Peng Guo, Fei Liu, Mingfeng Ma, Quancai Li
Marine Drugs.2024; 22(12): 573. CrossRef
Persistence of newly prescribed 5-aminosalicylic acid in patients with ulcerative colitis: A nationwide comprehensive database study
Tatsuya Noda, Kotaro Kuwaki, Munehito Machida, Yasuyuki Okumura, Yuichi Nishioka, Tomoya Myojin, Tomoaki Imamura, Barry Kweh
PLOS ONE.2024; 19(12): e0316181. CrossRef
Manipulating Microbiota in Inflammatory Bowel Disease Treatment: Clinical and Natural Product Interventions Explored
Mengjie Zhu, Yijie Song, Yu Xu, Hongxi Xu
International Journal of Molecular Sciences.2023; 24(13): 11004. CrossRef
Risk factors for intolerance of oral 5‐aminosalicylic acid preparations in pediatric ulcerative colitis
Naoki Abe, Naomi Iwata, Ryuhei Yasuoka, Daisuke Nishida, Asami Oohara, Haruna Nakaseko, Shiro Sugiura, Shinji Kawabe
Pediatrics International.2023;[Epub] CrossRef
CURRENT STATUS, PROBLEMS AND PROSPECTS OF ULCERATIVE COLITIS MEDICAL CORRECTION (LITERATURE REVIEW)
T. O. Briukhanova, O. A. Nakonechna, O. V Babenko
Bulletin of Problems Biology and Medicine.2023; 1(3): 28. CrossRef
Significance of 5-Aminosalicylic Acid Intolerance in the Clinical Management of Ulcerative Colitis
Yohei Mikami, Junya Tsunoda, Shohei Suzuki, Ichiro Mizushima, Hiroki Kiyohara, Takanori Kanai
Digestion.2023; 104(1): 58. CrossRef
Genetic Background of Mesalamine-induced Fever and Diarrhea in Japanese Patients with Inflammatory Bowel Disease
Kaoru Suzuki, Yoichi Kakuta, Takeo Naito, Tetsuya Takagawa, Hiroyuki Hanai, Hiroshi Araki, Yu Sasaki, Hirotake Sakuraba, Makoto Sasaki, Tadakazu Hisamatsu, Satoshi Motoya, Takayuki Matsumoto, Motoyuki Onodera, Yoh Ishiguro, Hiroshi Nakase, Akira Andoh, Sa
Inflammatory Bowel Diseases.2022; 28(1): 21. CrossRef
Classification and clinical features of adverse drug reactions in patients with ulcerative colitis treated with 5‐aminosalicylate acid: a single-center, observational study
Yuri Tsujii, Tsutomu Nishida, Naoto Osugi, Yoshifumi Fujii, Aya Sugimoto, Dai Nakamatsu, Kaori Mukai, Kengo Matsumoto, Shiro Hayashi, Masashi Yamamoto, Sachiko Nakajima
Scandinavian Journal of Gastroenterology.2022; 57(2): 190. CrossRef
The Prognostic Value of Residual Nonrectal Inflammation in Ulcerative Colitis
Eun Ae Kang
Gut and Liver.2022; 16(3): 487. CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. CrossRef
The emerging microbiome‐based approaches to IBD therapy: From SCFAs to urolithin A
Mohammad Rudiansyah, Saade Abdalkareem Jasim, Bakhadir S. Azizov, Vadim Samusenkov, Walid Kamal Abdelbasset, Ghulam Yasin, Hawraa Jabbar Mohammad, Mohammed Abed Jawad, Trias Mahmudiono, Seyed Reza Hosseini‐Fard, Rasoul Mirzaei, Sajad Karampoor
Journal of Digestive Diseases.2022; 23(8-9): 412. CrossRef
Multicenter survey on mesalamine intolerance in patients with ulcerative colitis
Sakiko Hiraoka, Akiko Fujiwara, Tatsuya Toyokawa, Reiji Higashi, Yuki Moritou, Shinjiro Takagi, Kazuhiro Matsueda, Seiyuu Suzuki, Jiro Miyaike, Toshihiro Inokuchi, Masahiro Takahara, Jun Kato, Hiroyuki Okada
Journal of Gastroenterology and Hepatology.2021; 36(1): 137. CrossRef
Enteric-coated gelatin nanoparticles mediated oral delivery of 5-aminosalicylic acid alleviates severity of DSS-induced ulcerative colitis
Anas Ahmad, Md. Meraj Ansari, Rakesh Kumar Mishra, Ajay Kumar, Akshay Vyawahare, Rahul Kumar Verma, Syed Shadab Raza, Rehan Khan
Materials Science and Engineering: C.2021; 119: 111582. CrossRef
Bacteriotherapy for inflammatory bowel disease
Yusuke Yoshimatsu, Yohei Mikami, Takanori Kanai
Inflammation and Regeneration.2021;[Epub] CrossRef
Treatment of inflammatory bowel diseases: focusing on 5-aminosalicylates and immunomodulators
You Sun Kim
Journal of the Korean Medical Association.2021; 64(9): 596. CrossRef
The Communication Between Intestinal Microbiota and Ulcerative Colitis: An Exploration of Pathogenesis, Animal Models, and Potential Therapeutic Strategies
Yu Hu, Zhen Ye, Mingquan Wu, Yingqi She, Linzhen Li, Yujie Xu, Kaihua Qin, Zhipeng Hu, Maoyi Yang, Fating Lu, Qiaobo Ye
Frontiers in Medicine.2021;[Epub] CrossRef
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Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef
5‐aminosalicylate–intolerant patients are at increased risk of colectomy for ulcerative colitis
Shuji Hibiya, Yusuke Matsuyama, Toshimitsu Fujii, Chiaki Maeyashiki, Eiko Saito, Kimiko Ito, Hiromichi Shimizu, Ami Kawamoto, Maiko Motobayashi, Kento Takenaka, Masakazu Nagahori, Masayuki Kurosaki, Tsunehito Yauchi, Kazuo Ohtsuka, Takeo Fujiwara, Ryuichi
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Satohiro Matsumoto, Hirosato Mashima
Scientific Reports.2020;[Epub] CrossRef

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Inflammatory bowel diseases

Predictive factors for achievement of mucosal healing by budesonide 2-mg foam in ulcerative colitis: a pooled analysis of data from two clinical trials: Toshifumi Hibi, Makoto Naganuma, Eisei Oda, Yoji Yamada, Yoshitomo Chujoh, Ryoichi Yoshihara, Mamoru Watanabe; Intest Res 2020;18(1):56-68. Published online December 11, 2019; DOI: https://doi.org/10.5217/ir.2019.00064

Abstract PDF PubReader ePub

Background/Aims
Mucosal healing (MH) of distal lesions in ulcerative colitis (UC) has recently been confirmed with budesonide 2-mg foam (BF) treatment in 2 clinical trials; however, few studies have investigated the predictive factors for complete MH.
Methods
We conducted a post hoc analysis using pooled data from phase II and III clinical trials evaluating the efficacy and safety of BF for UC. Additionally, we analyzed the relationships between complete MH and baseline factors and clinical symptoms from baseline to week 6.
Results
Among the 291 Japanese patients from the 2 pooled clinical studies, 119 patients in the BF twice a day group and 117 in the placebo group were included in the full analysis set. The proportion of patients with a rectal bleeding (RB) subscore of 0 was significantly higher in the BF group than in the placebo group after a 5-day treatment (P<0.05). After a 2-day treatment, significantly more patients in the BF group had a stool frequency (SF) subscore of 0 than patients in the placebo group (P<0.05). Multivariate analysis showed that complete MH at week 6 was influenced by baseline SF subscore and 5-aminosalicylic acid (5-ASA) enema or suppository use (P=0.0086 and P=0.0015, respectively). The relationship between complete MH at week 6 and RB subscore after week 2 was also confirmed.
Conclusions
Normal SF at baseline, history of 5-ASA topical product use, and elimination of RB after week 2 are suggested predictors of complete MH at week 6 with twice-daily BF treatment.

Citations

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Early resolution of bowel urgency by budesonide foam enema results in improved quality of life in patients with ulcerative colitis: a multicenter prospective observational study
Taku Kobayashi, Kei Moriya, Toshimitsu Fujii, Shigeki Bamba, Shinichiro Shinzaki, Akihiro Yamada, Takashi Hisabe, Shintaro Sagami, Shuji Hibiya, Takahiro Amano, Noritaka Takatsu, Katsutoshi Inagaki, Ken-ichi Iwayama, Toshifumi Hibi
Intestinal Research.2025; 23(2): 157. CrossRef
Impact of twice‐daily budesonide foam administration on early clinical response and endoscopic remission in patients with ulcerative colitis: a post hoc analysis
Kenji Watanabe, Fumihito Hirai, Kiyonori Kobayashi, Ken Takeuchi, Shinsuke Kurosu, Katsutoshi Inagaki, Ken‐ichi Iwayama, Makoto Naganuma
Journal of Gastroenterology and Hepatology.2024; 39(11): 2367. CrossRef
Precision medicine and drug optimization in adult inflammatory bowel disease patients
Sophie Vieujean, Edouard Louis
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
The Prognostic Value of Residual Nonrectal Inflammation in Ulcerative Colitis
Eun Ae Kang
Gut and Liver.2022; 16(3): 487. CrossRef
Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
Ryosuke Miyazaki, Toshiyuki Sakurai, Mariko Shimada, Yuko Iwashita, Naoki Shibuya, Yoshihiro Akita, Haruna Miyashita, Yuki Maruyama, Masayuki Saruta
BMC Gastroenterology.2022;[Epub] CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. CrossRef
Budesonide MMX in the Treatment of Ulcerative Colitis: Current Perspectives on Efficacy and Safety
Giovanni Maconi, Deborah Camatta, Rosanna Cannatelli, Francesca Ferretti, Anna Carvalhas Gabrielli, Sandro Ardizzone
Therapeutics and Clinical Risk Management.2021; Volume 17: 285. CrossRef

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Review

IBD

Current new challenges in the management of ulcerative colitis: Tomohiro Fukuda, Makoto Naganuma, Takanori Kanai; Intest Res 2019;17(1):36-44. Published online January 25, 2019; DOI: https://doi.org/10.5217/ir.2018.00126

Abstract PDF PubReader ePub

Ulcerative colitis (UC) is a chronic inflammatory condition of the gastrointestinal tract. Although the cause of UC is postulated to be multifactorial in nature, including genetic predisposition, epithelial barrier defects, dysregulation of immune responses, and environmental factors, the specific pathogenesis of UC is still incompletely understood. In the treatment of UC so far, a method of suppressing immunity and treating it has been mainstream. Immunosuppressant drugs, including thiopurines (azathioprine or 6-mercaptopurine), anti-tumor necrosis factor-α (anti-TNF-α) antibody (infliximab and adalimumab), and calcineurin inhibitor, can be used in treat patients with corticosteroid-dependent and/or corticosteroid-refractory moderateto- severe UC. Recently, in addition to such a conventional therapeutic agent, golimumab, which is the first transgenic human monoclonal anti-TNF-α antibody to be fabricated, anti α-4/β-7 integrin antibody, and Janus kinase inhibitor have been reported to novel immunosuppressant therapy. Furthermore, other treatments with unique mechanisms different from immunosuppression, have also been suggested, including fecal microbiota transplantation and Indigo naturalis, which is a Chinese herbal medicine. We compared the features and efficacy of these new treatments. In this issue, the features and treatment options for these new treatments is reviewed.

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Soo-Kyung Park, Sangsoo Kim, Gi-Young Lee, Sung-Yoon Kim, Wan Kim, Chil-Woo Lee, Jong-Lyul Park, Chang-Hwan Choi, Sang-Bum Kang, Tae-Oh Kim, Ki-Bae Bang, Jaeyoung Chun, Jae-Myung Cha, Jong-Pil Im, Kwang-Sung Ahn, Seon-Young Kim, Dong-Il Park
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Dermatologische Komplikationen unter Therapie mit Biologika bei entzündlichen Autoimmunerkrankungen
Wiebke Sondermann, Saskia Herz, Elsa Sody, Andreas Körber
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Case Report

IBD

5-Aminosalicylic acid aggravates colitis mimicking exacerbation of ulcerative colitis: Jun Miyoshi, Katsuyoshi Matsuoka, Atsushi Yoshida, Makoto Naganuma, Tadakazu Hisamatsu, Tomoharu Yajima, Nagamu Inoue, Susumu Okamoto, Yasushi Iwao, Haruhiko Ogata, Fumiaki Ueno, Toshifumi Hibi, Takanori Kanai; Intest Res 2018;16(4):635-640. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00015

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Ulcerative colitis (UC) is one of the major clinical phenotypes of inflammatory bowel diseases. Although 5-aminosalicylic acid (5-ASA) is widely used for UC and its efficacy and safety have been demonstrated, a few patients paradoxically develop a severe exacerbation of colitis by 5-ASA administration. It is crucial to know clinical features including endoscopic findings in this condition for making a correct diagnosis and a prompt decision to withdraw the medication. Here, we report case series with UC exacerbated by 5-ASA. Medical records of 8 UC patients experiencing an exacerbation of colitis after induction of 5-ASA that was improved by the withdrawal of 5-ASA but also re-aggravated by dose increase or re-administration of 5-ASA were reviewed. The patients were newly diagnosed with UC, started 5-ASA and developed an exacerbation in approximately 2 to 3 weeks. They did not appear to have systemic allergic reactions. Seven of the 8 patients had a high fever. Three of 5 patients who undertook total colonoscopy showed right-side-dominant colitis. These findings suggest clinical characteristics in this condition. Further assessment of clinical and endoscopic features in more cases is necessary for establishing diagnostic criteria and understanding underlying mechanisms in those cases where 5-ASA aggravates the colitis.

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Risk factors for intolerance of oral 5‐aminosalicylic acid preparations in pediatric ulcerative colitis
Naoki Abe, Naomi Iwata, Ryuhei Yasuoka, Daisuke Nishida, Asami Oohara, Haruna Nakaseko, Shiro Sugiura, Shinji Kawabe
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Yohei Mikami, Junya Tsunoda, Shohei Suzuki, Ichiro Mizushima, Hiroki Kiyohara, Takanori Kanai
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Lauren Sahakian, Ainsley M. Robinson, Linda Sahakian, Rhian Stavely, Mark R. Kelley, Kulmira Nurgali
Biomolecules.2023; 13(11): 1569. CrossRef

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Brief Communication

IBD

Effect of elemental diet combined with infliximab dose escalation in patients with Crohn's disease with loss of response to infliximab: CERISIER trial: Tadakazu Hisamatsu, Reiko Kunisaki, Shiro Nakamura, Tomoyuki Tsujikawa, Fumihito Hirai, Hiroshi Nakase, Kenji Watanabe, Kaoru Yokoyama, Masakazu Nagahori, Takanori Kanai, Makoto Naganuma, Hirofumi Michimae, Akira Andoh, Akihiro Yamada, Tadashi Yokoyama, Noriko Kamata, Shinji Tanaka, Yasuo Suzuki, Toshifumi Hibi, Mamoru Watanabe; Intest Res 2018;16(3):494-498. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.494

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Citations

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Journal of Crohn's and Colitis.2025;[Epub] CrossRef
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Fleur T. R. Wijers, Suzanne M. C. van Zundert, Charlotte M. Verburgt, Nikki van der Kruk, Johan E. Van Limbergen, Nicolette J. Wierdsma
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Nutrition and dietary therapy in paediatric inflammatory bowel disease
Konstantinos Gerasimidis
Clinical Nutrition ESPEN.2025; 67: 233. CrossRef
Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial
Jian Kang, Jing Wang, Juan Su, Wei Wang, Yueyue Lu, Zhishun Tang, Liping Zou, Anning Yin, Jiao Li, Haixia Ren, Qian Zhou, Huipeng Wan, Ping An
United European Gastroenterology Journal.2025;[Epub] CrossRef
Prospective study of an adalimumab combined with partial enteral nutrition in the induction period of Crohn’s disease
Sisi Zhou, Zeyu Huang, Wenjing Hou, Yiting Lin, Jing Yu
Inflammation Research.2024; 73(2): 199. CrossRef
Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis
Emma P Halmos, Lihi Godny, Julie Vanderstappen, Chen Sarbagili-Shabat, Vaios Svolos
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Atsuhito Kubota, Shungo Imai, Ryoichi Aoyagi, Wataru Murase, Masaru Terasaki, Mitsuru Sugawara, Yoh Takekuma, Hiroyuki Kojima
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Hiroshi Nakase, Motoi Uchino, Shinichiro Shinzaki, Minoru Matsuura, Katsuyoshi Matsuoka, Taku Kobayashi, Masayuki Saruta, Fumihito Hirai, Keisuke Hata, Sakiko Hiraoka, Motohiro Esaki, Ken Sugimoto, Toshimitsu Fuji, Kenji Watanabe, Shiro Nakamura, Nagamu I
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Pabitra Sahu, Saurabh Kedia, Vineet Ahuja, Rakesh K. Tandon
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Teresa Di Chio, Christiane Sokollik, Diego G. Peroni, Lara Hart, Giacomo Simonetti, Franziska Righini-Grunder, Osvaldo Borrelli
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Sanchit Sharma, Arti Gupta, Saurabh Kedia, Samagra Agarwal, Namrata Singh, Sandeep Goyal, Saransh Jain, Vipin Gupta, Pabitra Sahu, Sudheer Kumar Vuyyuru, Bhaskar Kante, Raju Sharma, Rajesh Panwar, Peush Sahni, Govind Makharia, Vineet Ahuja
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Lara Hart, Charlotte M. Verburgt, Eytan Wine, Mary Zachos, Alisha Poppen, Mallory Chavannes, Johan Van Limbergen, Nikhil Pai
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Fumihito Hirai, Teruyuki Takeda, Yasumichi Takada, Masahiro Kishi, Tsuyoshi Beppu, Noritaka Takatsu, Masaki Miyaoka, Takashi Hisabe, Kenshi Yao, Tosiharu Ueki
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Jun Miyoshi, Daisuke Saito, Mio Nakamura, Miki Miura, Tatsuya Mitsui, Toru Kudo, Shinnosuke Murakami, Minoru Matsuura, Tadakazu Hisamatsu
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Original Article

IBD

β-(1,3)-Glucan derived from Candida albicans induces inflammatory cytokines from macrophages and lamina propria mononuclear cells derived from patients with Crohn's disease: Kiyoto Mori, Makoto Naganuma, Shinta Mizuno, Hiroaki Suzuki, Mina T. Kitazume, Katsuyoshi Shimamura, Sayako Chiba, Akira Sugita, Katsuyoshi Matsuoka, Tadakazu Hisamatsu, Takanori Kanai; Intest Res 2018;16(3):384-392. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.384

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Background/Aims

Recent research has highlighted the importance of interactions between commensal fungi and intestinal inflammation. However, there are few studies investigating whether commensal fungi contribute to inflammation in patients with Crohn's disease (CD). The aim of this study is to investigate reveal interactions between commensal fungi and host immune cells in CD.

Methods

CD14-positive monocytes were isolated from peripheral blood mononuclear cells from healthy human volunteers and then differentiated in the presence of macrophage colony-stimulating factor (M-CSF) (referred to as M-macrophages, M-Mϕs) or M-CSF and interferon-γ (IFN-γ) (referred to as M-gamma macrophages, Mγ-Mϕs). Cytokine production by these in vitro differentiated macrophages in response to β-(1,3)-glucan was analyzed by flow cytometry. Expression of Dectin-1 was examined using flow cytometry, western blotting, and quantitative reverse transcription-polymerase chain reaction. Cytokine production by in vitro differentiated macrophages in response to β-(1,3)-glucan was measured in the presence of an anti-Dectin-1 receptor antagonist, anti-Syr, or an anti-Fas-1 antibody. Cytokine production by lamina propria mononuclear cells (LPMCs) derived from CD patients in response to β-(1,3)-glucan was also analyzed.

Results

Mγ-Mϕs produced a large amount of tumor necrosis factor-α (TNF-α) and interleukin-6 in response to β-(1,3)-glucan. Dectin-1 expression was significantly higher in Mγ-Mϕs than in M-Mϕs. The increase in TNF-α production by Mγ-Mϕs stimulated with glucan was reversed by blocking Dectin-1, Syr or Fas-1. LPMCs derived from CD patients stimulated with β-(1,3)-glucan produced significantly higher amount of TNF-α than LPMCs derived from UC patients.

Conclusions

These results suggest that commensal fungal microbiota may contribute to the pathogenesis of CD by inducing macrophages-derived pro-inflammatory cytokines.

Citations

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Heat Shock Protein SSA1 Enriched in Hypoxic Secretome of Candida albicans Exerts an Immunomodulatory Effect via Regulating Macrophage Function
Wei Teng, Phawinee Subsomwong, Kouji Narita, Akio Nakane, Krisana Asano
Cells.2024; 13(2): 127. CrossRef
Antifungal immunity mediated by C-type lectin receptors may be a novel target in immunotherapy for urothelial bladder cancer
Tianhang Li, Tianyao Liu, Zihan Zhao, Yuchen Pan, Xinyan Xu, Yulin Zhang, Shoubin Zhan, Shengkai Zhou, Wenjie Zhu, Hongqian Guo, Rong Yang
Frontiers in Immunology.2022;[Epub] CrossRef
Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease
Katia Farias e Silva, Hayandra F Nanini, Cynthia Machado Cascabulho, Siane L B Rosas, Patricia T Santana, Antonio José de V Carneiro, Elias Anaissie, Marcio Nucci, Heitor Siffert Pereira de Souza
World Journal of Gastroenterology.2021; 27(9): 866. CrossRef
Effects of Medicinal Fungi-Derived β-Glucan on Tumor Progression
Vaclav Vetvicka, Tamara V. Teplyakova, Alexandra B. Shintyapina, Tatiana A. Korolenko
Journal of Fungi.2021; 7(4): 250. CrossRef
The Role of IL-17-Producing Cells in Cutaneous Fungal Infections
Yu Sawada, Ayako Setoyama, Yumiko Sakuragi, Natsuko Saito-Sasaki, Haruna Yoshioka, Motonobu Nakamura
International Journal of Molecular Sciences.2021; 22(11): 5794. CrossRef

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Case Report

IBD

Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis: Kosaku Nanki, Shinta Mizuno, Katsuyoshi Matsuoka, Keiko Ono, Shinya Sugimoto, Hiroki Kiyohara, Mari Arai, Moeko Nakashima, Kozue Takeshita, Keiichiro Saigusa, Mitsutoshi Senoh, Tadashi Fukuda, Makoto Naganuma, Haru Kato, Wataru Suda, Masahira Hattori, Takanori Kanai; Intest Res 2018;16(1):142-146. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.142

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Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.

Citations

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Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study
Puo‐Hsien Le, Chyi‐Liang Chen, Chia‐Jung Kuo, Pai‐Jui Yeh, Chien‐Chang Chen, Yi‐Ching Chen, Cheng‐Tang Chiu, Hao‐Tsai Cheng, Yung‐Kuan Tsou, Yu‐Bin Pan, Cheng‐Hsun Chiu
The Kaohsiung Journal of Medical Sciences.2025;[Epub] CrossRef
Comparative Efficacy of Fecal Microbiota Transplantation in Treating Refractory or Recurrent Clostridioides difficile Infection among Patients with and without Inflammatory Bowel Disease: A Retrospective Cohort Study
Jing-Han Chen, Cheng-Hsun Chiu, Chien-Chang Chen, Yi-Ching Chen, Pai-Jui Yeh, Chia-Jung Kuo, Cheng-Tang Chiu, Hao-Tsai Cheng, Yu-Bin Pan, Puo-Hsien Le
Biomedicines.2024; 12(7): 1396. CrossRef
Case report: Fecal microbiota transplant for Clostridium difficile infection in a pregnant patient with acute severe ulcerative colitis
Hanyu Wang, Feihong Deng, Min Luo, Xuehong Wang
Frontiers in Immunology.2024;[Epub] CrossRef
The first international Rome consensus conference on gut microbiota and faecal microbiota transplantation in inflammatory bowel disease
Loris Riccardo Lopetuso, Sara Deleu, Lihi Godny, Valentina Petito, Pierluigi Puca, Federica Facciotti, Harry Sokol, Gianluca Ianiro, Luca Masucci, Maria Abreu, Iris Dotan, Samuel Paul Costello, Ailsa Hart, Tariq H Iqbal, Sudarshan Paramsothy, Maurizio San
Gut.2023; 72(9): 1642. CrossRef
Fecal microbiota transplantation as therapy for recurrent Clostridioides difficile infection is associated with amelioration of delirium and accompanied by changes in fecal microbiota and the metabolome
Kazuyoshi Gotoh, Yoshihiko Sakaguchi, Haru Kato, Hayato Osaki, Yasutaka Jodai, Mitsutaka Wakuda, Akira Také, Shunji Hayashi, Eri Morita, Takehiko Sugie, Yoichiro Ito, Naoki Ohmiya
Anaerobe.2022; 73: 102502. CrossRef
Management of Clostridioides difficile infection in patients with inflammatory bowel disease
Sahil Khanna
Intestinal Research.2021; 19(3): 265. CrossRef
Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment
Xiao Yan Guo, Xin Juan Liu, Jian Yu Hao
Journal of Digestive Diseases.2020; 21(3): 147. CrossRef
RecurrentClostridium difficileInfection: Risk Factors, Treatment, and Prevention
Jung Hoon Song, You Sun Kim
Gut and Liver.2019; 13(1): 16. CrossRef
Current Status of Clostridium Difficile Infection
Akira Andoh, Shigeki Bamba
Nippon Daicho Komonbyo Gakkai Zasshi.2018; 71(10): 456. CrossRef

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Original Articles

Long-term safety and efficacy of adalimumab for intestinal Behçet's disease in the open label study following a phase 3 clinical trial: Nagamu Inoue, Kiyonori Kobayashi, Makoto Naganuma, Fumihito Hirai, Morio Ozawa, Dilek Arikan, Bidan Huang, Anne M. Robinson, Roopal B. Thakkar, Toshifumi Hibi; Intest Res 2017;15(3):395-401. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.395

Abstract PDF PubReader ePub

Background/Aims

Intestinal Behçet's disease (BD) is an immune-mediated inflammatory disorder. We followed up the patients and evaluated safety profile and effectiveness of adalimumab for the treatment of intestinal BD through 100 weeks rolled over from the 52 week clinical trial (NCT01243671).

Methods

Patients initiated adalimumab therapy at 160 mg at week 0, followed by 80 mg at week 2, followed by 40 mg every other week until the end of the study. Long-term safety and all adverse events (AEs) were examined. The efficacy was assessed on the basis of marked improvement (MI) and complete remission (CR) using a composite efficacy index, which combined global gastrointestinal symptoms and endoscopic assessments.

Results

Twenty patients were enrolled in this study; 15 patients received adalimumab treatment until study completion. The incidence of AEs through week 100 was 544.4 events/100 person-years, which was comparable to the incidence through week 52 (560.4 events/100 person-years). No unexpected trend was observed and adalimumab was well tolerated. At weeks 52 and 100, 60.0% and 40.0% of patients showed MI, respectively, and 20.0% and 15.0% of patients showed CR, respectively.

Conclusions

This report demonstrates 2 years safety and effectiveness of adalimumab in intestinal BD patients. Patients with intestinal BD refractory to conventional treatment receiving up to 2 years of adalimumab treatment demonstrated safety outcomes consistent with the known profile of adalimumab, and the treatment led to sustained reduction of clinical and endoscopic disease activity.

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Positive antiphospholipid antibodies and pulmonary embolism in a patient with adalimumab-induced lupus
Masaaki Uehara, Shinya Matsushita, Satsuki Aochi, Motohisa Yamamoto
Modern Rheumatology Case Reports.2023; 7(1): 68. CrossRef
Hemorrhagic gastric ulcer in a patient with Behcet's disease successfully treated with infliximab
Shun Fujiwara, Ami Kawamoto, Maiko Motobayashi, Shuji Hibiya, Kento Takenaka, Hiromichi Shimizu, Eiko Saito, Toshimitsu Fujii, Masakazu Nagahori, Daisuke Kawata, Natsuka Umezawa, Tadashi Hosoya, Shinsuke Yasuda, Kazuo Ohtsuka, Ryuichi Okamoto
DEN Open.2023;[Epub] CrossRef
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Teresa Giani, Angela Flavia Luppino, Giovanna Ferrara
Pediatric Drugs.2023; 25(2): 165. CrossRef
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Jae Hee Cheon, Hyun-Soo Kim, Dong Soo Han, Sung Kook Kim, Sung Jae Shin, Joo Sung Kim, Byong Duk Ye, Geun Am Song, YoungJa Lee, Youngdoe Kim, Yoosun Lee, Won Ho Kim
Gut and Liver.2023; 17(5): 777. CrossRef
Effectiveness and safety of adalimumab in patients with intestinal Behçet’s disease: a real-world prospective observational study in South Korea
Jongwook Yu, Sung Jae Shin, Yune-Jung Park, Hyung Wook Kim, Bo-In Lee, Byong Duk Ye, Geun-Tae Kim, Sung Kook Kim, Joo Sung Kim, Young-Ho Kim, Seonjeong Jeong, Jae Hee Cheon
BMC Gastroenterology.2023;[Epub] CrossRef
The efficacy and safety of anti‐tumor necrosis factor agents in the treatment of intestinal Behcet's disease, a systematic review and meta‐analysis
Mengyuan Zhang, Jinjing Liu, Tingting Liu, Wei Han, Xiaoyin Bai, Gechong Ruan, Hong Lv, Huijun Shu, Yue Li, Ji Li, Bei Tan, Weiyang Zheng, Hui Xu, Wenjie Zheng, Hong Yang, Jiaming Qian
Journal of Gastroenterology and Hepatology.2022; 37(4): 608. CrossRef
Efficacy and predictor of anti-TNFα agents in patients with intestinal Behçet's disease
Haruka Miyazaki, Daisuke Watanabe, Norihiro Okamoto, Eri Tokunaga, Yuna Ku, Haruka Takenaka, Namiko Hoshi, Makoto Ooi, Yuzo Kodama
BMC Gastroenterology.2022;[Epub] CrossRef
New insights on multigenic autoinflammatory diseases
Petros Efthimiou, Olga Petryna, Priscila Nakasato, Apostolos Kontzias
Therapeutic Advances in Musculoskeletal Disease.2022;[Epub] CrossRef
Anti-TNF-α agents for refractory intestinal Behçet’s disease: case series and meta-analysis
Shukai Zhan, Caiguang Liu, Na Li, Tong Li, Zhenyi Tian, Min Zhao, Dongxuan Wu, Minhu Chen, Zhirong Zeng, Xiaojun Zhuang
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef
Clinical Manifestations and Management of Pediatric Behçet’s Disease
Ya-Chiao Hu, Bor-Luen Chiang, Yao-Hsu Yang
Clinical Reviews in Allergy & Immunology.2021; 61(2): 171. CrossRef
Advances in Management of Intestinal Behçet’s Disease: A Perspective From Gastroenterologists
Jae Hee Cheon
Journal of Rheumatic Diseases.2021; 28(1): 4. CrossRef
Mucosal healing in intestinal Behçet's disease: A systematic review and meta‐analysis
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30 Crossref

Single fecal microbiota transplantation failed to change intestinal microbiota and had limited effectiveness against ulcerative colitis in Japanese patients: Shinta Mizuno, Kosaku Nanki, Katsuyoshi Matsuoka, Keiichiro Saigusa, Keiko Ono, Mari Arai, Shinya Sugimoto, Hiroki Kiyohara, Moeko Nakashima, Kozue Takeshita, Makoto Naganuma, Wataru Suda, Masahira Hattori, Takanori Kanai; Intest Res 2017;15(1):68-74. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.68

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

Recent developments in analytical techniques including next-generation sequencing have clarified the correlation between intestinal microbiota and inflammatory bowel disease. Fecal microbiota transplantation (FMT) for patients with ulcerative colitis (UC) is proposed as a potential approach to resolving their dysbiosis; however, its safety and efficacy have not been confirmed. This single-arm, open-label, non-randomized study aimed to evaluate the safety and efficacy of FMT for Japanese patients with UC as the first registered clinical trial in Japan.

Methods

We enrolled 10 patients with active UC despite medical therapy. The donors were the patients' relatives and were carefully screened for infectious diseases. Fecal material was administered via colonoscopy, and the primary endpoint was the presence or absence of serious adverse events related to FMT. The secondary endpoint was a change in partial Mayo score at 12 weeks post-FMT. Scores ≤2 were considered a clinical response. Fecal samples were collected to follow changes in gut microbiota, while extracted complementary DNA were analyzed by a next-generation sequencer. We obtained written informed consent from all patients and donors. This study was approved by our Institutional Review Board and is registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN 000012814).

Results

Five patients with moderate disease and five with severe disease were enrolled. No severe adverse effects were observed. One patient achieved clinical response; however, none of the patients' microbiota diversity recovered to the donor levels.

Conclusions

The use of single FMT for UC was safe; however, we failed to show its clinical efficacy and potential to change the intestinal microbiota.

Citations

Citations to this article as recorded by

Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: A Systematic Review and Meta-analysis
Benoît Levast, Mathieu Fontaine, Stéphane Nancey, Pierre Dechelotte, Joël Doré, Philippe Lehert
Clinical and Translational Gastroenterology.2023; 14(5): e00568. CrossRef
Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans
Oshrit Shtossel, Sondra Turjeman, Alona Riumin, Michael R. Goldberg, Arnon Elizur, Yarin Bekor, Hadar Mor, Omry Koren, Yoram Louzoun
Microbiome.2023;[Epub] CrossRef
Transfer of FRozen Encapsulated multi-donor Stool filtrate for active ulcerative Colitis (FRESCO): study protocol for a prospective, multicenter, double-blind, randomized, controlled trial
Andreas Stallmach, Philip Grunert, Johannes Stallhofer, Bettina Löffler, Michael Baier, Jürgen Rödel, Michael Kiehntopf, Sophie Neugebauer, Dietmar H. Pieper, Howard Junca, Andrea Tannapfel, Ute Merkel, Ulrike Schumacher, Maria Breternitz-Gruhne, Tabitha
Trials.2022;[Epub] CrossRef
An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis
Taobi Huang, Jinlan Xu, Maoying Wang, Ke Pu, Longquan Li, Huiyun Zhang, Yuan Liang, Weiming Sun, Yuping Wang
Medicine.2022; 101(30): e29790. CrossRef
Hot topics on fecal microbiota transplantation for the treatment of inflammatory bowel disease
Xiaochen Zhang, Dai Ishikawa, Toshifumi Ohkusa, Shinji Fukuda, Akihito Nagahara
Frontiers in Medicine.2022;[Epub] CrossRef
The Effects of Multi-Donor Fecal Microbiota Transplantation Capsules Combined with Thalidomide on Hormone-Dependent Ulcerative Colitis
Xiao-He Guo, Yan-Li Zhu, Lu Yang, Wen-Jing Li, Xue-Fang Du
Infection and Drug Resistance.2022; Volume 15: 7495. CrossRef
Fecal microbiota transplantation for ulcerative colitis
Katsuyoshi Matsuoka
Immunological Medicine.2021; 44(1): 30. CrossRef
Bacteriotherapy for inflammatory bowel disease
Yusuke Yoshimatsu, Yohei Mikami, Takanori Kanai
Inflammation and Regeneration.2021;[Epub] CrossRef
Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis
Valentin Mocanu, Sabitha Rajaruban, Jerry Dang, Janice Y. Kung, Edward C. Deehan, Karen L. Madsen
Journal of Clinical Medicine.2021; 10(5): 959. CrossRef
Current status, complications and prospects of fecal microbiota transplantation therapy
Ohara Tadashi
Archives of Pathology and Clinical Research.2021; 5(1): 004. CrossRef
Fecal Microbial Transplantation in Critically Ill Patients—Structured Review and Perspectives
Ivana Cibulková, Veronika Řehořová, Jan Hajer, František Duška
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Abnormal Intestinal Microbiome in Medical Disorders and Potential Reversibility by Fecal Microbiota Transplantation
Herbert L. DuPont, Zhi-Dong Jiang, Andrew W. DuPont, Netanya S. Utay
Digestive Diseases and Sciences.2020; 65(3): 741. CrossRef
Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment
Xiao Yan Guo, Xin Juan Liu, Jian Yu Hao
Journal of Digestive Diseases.2020; 21(3): 147. CrossRef
Fecal microbiota transplantation in inflammatory bowel disease patients: A systematic review and meta-analysis
Luciane de Fátima Caldeira, Helena H. Borba, Fernanda S. Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo, Udai P. Singh
PLOS ONE.2020; 15(9): e0238910. CrossRef
Fecal Microbiota Transplantation for Ulcerative Colitis: An Evolving Therapy
Ajit Sood, Arshdeep Singh, Vandana Midha, Ramit Mahajan, Dina Kao, David T Rubin, Charles N Bernstein
Crohn's & Colitis 360.2020;[Epub] CrossRef
Efficacy and safety of fecal microbiota transplantation for treating patients with ulcerative colitis: A systematic review and meta‐analysis
Hai Lan Zhao, Shu Zhen Chen, Hao Ming Xu, You Lian Zhou, Jie He, Hong Li Huang, Jing Xu, Yu Qiang Nie
Journal of Digestive Diseases.2020; 21(10): 534. CrossRef
Fecal Microbiota Transplantation in Intestinal Disorders: A Primer for Physicians
Ajit Sood, Vandana Midha, Harmeet Kaur, Arshdeep Singh
Journal of Gastrointestinal Infections.2020; 10(1): 16. CrossRef
Multi-session fecal microbiota transplantation using colonoscopy has favorable outcomes for the treatment of steroid-dependent ulcerative colitis
Young-Seok Cho
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Jung Hoon Song, You Sun Kim
Gut and Liver.2019; 13(1): 16. CrossRef
1) Microbiota and Gastrointestinal Diseases
Takanori Kanai
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Sonia Bouri, Ailsa Hart
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The Value of Fecal Microbiota Transplantation in the Treatment of Ulcerative Colitis Patients: A Systematic Review and Meta-Analysis
Yantian Cao, Bangjie Zhang, Yuanyuan Wu, Qingzhi Wang, Jie Wang, Fangfang Shen
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Kelley R. Jordan, Brett R. Loman, Michael T. Bailey, Leah M. Pyter
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Current Evidence for the Management of Inflammatory Bowel Diseases Using Fecal Microbiota Transplantation
Seong Ran Jeon, Jocelyn Chai, Christiana Kim, Christine H. Lee
Current Infectious Disease Reports.2018;[Epub] CrossRef
Is there a potential role of fecal microbiota transplantation in the treatment of inflammatory bowel disease?
Chang Soo Eun
Intestinal Research.2017; 15(2): 145. CrossRef
Bifidobacterium-Rich Fecal Donor May Be a Positive Predictor for Successful Fecal Microbiota Transplantation in Patients with Irritable Bowel Syndrome
Shinta Mizuno, Tatsuhiro Masaoka, Makoto Naganuma, Taishiro Kishimoto, Momoko Kitazawa, Shunya Kurokawa, Moeko Nakashima, Kozue Takeshita, Wataru Suda, Masaru Mimura, Masahira Hattori, Takanori Kanai
Digestion.2017; 96(1): 29. CrossRef
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Shun TANEMOTO, Tomohisa SUJINO, Takanori KANAI
Japanese Journal of Clinical Immunology.2017; 40(6): 408. CrossRef

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27 Crossref

Pregnancy outcome in women with inflammatory bowel disease treated with anti-tumor necrosis factor and/or thiopurine therapy: a multicenter study from Japan: Shunsuke Komoto, Satoshi Motoya, Yuji Nishiwaki, Toshiyuki Matsui, Reiko Kunisaki, Katsuyoshi Matsuoka, Naoki Yoshimura, Takashi Kagaya, Makoto Naganuma, Nobuyuki Hida, Mamoru Watanabe, Toshifumi Hibi, Yasuo Suzuki, Soichiro Miura, Ryota Hokari; Intest Res 2016;14(2):139-145. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.139

Abstract PDF PubReader ePub

Background/Aims

Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines.

Methods

This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines.

Results

Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037).

Conclusions

Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.

Citations

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Yang Zhang, Dandan Li, Heng Guo, Weina Wang, Xingang Li, Su Shen
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