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Impact of a gluten-free diet on patients with celiac disease, nonceliac gluten sensitivity, and asymptomatic controls. A need for healthier gluten-free foods
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Could Pirfenidone Also be Effective in Treating Intestinal Fibrosis?
Full text linkFibrogenesis is a physiological process of tissue repair triggered by acute inflammation, but in chronic inflammation it may become a progressive and independent process leading to fibrosis [...]
Non-medical Switching of Infliximab to CT-P13 Biosimilar in Inflammatory Bowel Disease: A Focus on the Definition of “Non-medical Switch”
No full textAdsorptive cytapheresis in ulcerative colitis: A non-pharmacological therapeutic approach revisited
Full text linkAdsorptive cytapheresis proves effective in a proportion of patients affected by ulcerative colitis. Relatively high cost and the need for apheresis facilities, prevented the widespread use of this therapeutic approach. More so following the introduction of anti-TNF alpha biosimilars which proved both effective and inexpensive. Anti-TNF alpha agents, however, are burdened by high rate of primary and secondary non-response and prompt switching to new, high-cost biologics, and small molecules. The present review analyzes advantages and disadvantages of adsorptive cytapheresis in the present clinical scenario and suggests its repositioning in the therapeutic workup of selected subgroups of ulcerative colitis patients. The extremely favorable safety profile makes adsorptive cytapheresis a viable therapeutic option in elderly and high-risk UC patients, as well as potential second-line treatment in corticosteroid-dependent patients and poor responders to first-line biologics
PPAR-γ with its anti-inflammatory and anti-fibrotic action could be an effective therapeutic target in IBD
Full text linkAbstract. – OBJECTIVE: Intestinal fibrosis is
a process characterized by an excessive deposition of Extracellular Matrix (ECM) proteins by
activated myofibroblasts and represents a consequence of a chronic inflammation that usually occurs during Inflammatory Bowel Disease
(IBD). The relationship between inflammation
and fibrosis in IBD remains still unclear and
nevertheless the recent pharmacological progresses, currently the only resolutive therapeutic strategy is surgery, especially when complications (stricture, stenosis and obstruction of
intestinal tracts) appear. As many different cellular types and molecular mechanisms are implicated in the pathogenesis of IBD, the identification of molecules able to counteract this process could be crucial.
MATERIALS AND METHODS: This is a literature review of several articles published on
PubMed databases.
RESULTS: A number of researches suggest
that Proliferator-Activated Receptor-gamma
(PPAR-γ) has both anti-inflammatory and anti-fibrotic effects in many organs. PPAR-γ has been
demonstrated to be able to downregulate pro-inflammatory cytokines production such as Interleukin (IL)-4,-5,-6 but also to interfere with profibrotic molecules as Platelet-Derived Growth
Factor (PDGF), IL-1 and Transforming Growth
Factor Beta (TGF-β), the main promoter of fibrosis. In preliminary clinical trials and in experimental models of intestinal fibrosis, natural and
chemical PPAR-γ ligands have ameliorated the
fibrotic process.
CONCLUSIONS: Since PPAR-γ could play a
crucial role in the development of the disease,
the research of new molecules, capable of ameliorating both inflammation and fibrosis lesions,
as PPAR-γ agonists, could represent a valid and
effective therapeutic approach for the prevention and treatment of IBD and intestinal fibrosis
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