1,721,349 research outputs found
Cytokines: from gut inflammation to colorectal cancer
No full textColorectal cancer represents a life-threatening complication of inflammatory bowel diseases. Statistics indicate that the risk to develop colorectal cancer is higher in patients affected by ulcerative colitis and to a lesser extent by Crohn's disease and that such a risk is directly proportional to the number of years of active disease. These observations suggest that chronic inflammation may substantially contribute to cancer development. However the molecular mechanisms underlying this process have been only recently started to be clarified. Indeed from the initial concept that the release of free radicals during inflammation might induce the accumulation of genetic mutations thus leading to the onset of dysplastic cells, it is now becoming clear that the large amount of cytokines and growth factors released during inflammation by immune and non immune cells may influence the carcinogenesis process. IL-6 and IL-23, cytokines which play key roles in the induction and maintenance of gut inflammation during IBDs, have been recently shown to influence the development and growth of colitis associated colorectal cancer. Moreover, the activation of the nuclear factor k B (NFkB), a transcription factor activated by several cytokines released during inflammation and responsible for many of their proinflammatory effects, have been shown to promote the growth of the colon tumors in experimental models
Le malattie infiammatorie croniche intestinali. In: Manuale di Gastroenterologia. UNIGASTRO. Coordinamento Nazionale Docenti Universitari di Gastroenterologia.
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Measuring disease activity in Crohn's disease
Full text linkIn the last few years the management of Crohn's disease (CD) has changed due to the introduction of new therapeutic agents that provide more alternative options in patients with severe diseases, introducing new concepts regarding treatment timing. At the moment, the absence of good predictors of disease outcome and a subclinical marker available to predict relapse during clinical remission are major problems in the management of CD. In recent decades, the evaluation of several variables has been proposed to address this issue, including disease behavior, clinical-endoscopic activity and intestinal damage. In particular, definition of mucosal restitution or healing after therapy has been proposed as a surrogate of efficacy and new goal of the therapy. Regarding this concept, several criticisms have been raised, such as the need to better define the role of mucosal healing in a transmural disease. In order to address this issue, new alternative techniques providing both extraluminal and luminal intestinal damage have been proposed, including ultrasonography, computed tomography and magnetic resonance imaging. © 2012 Springer Science+Business Media, LLC
New biologic therapies in patients with Inflammatory Bowel Disease [Nuovi farmaci biologici nelle Malattie Infiammatorie Croniche Intestinali]
No full textThe proven involvement of cytokines in the pathophysiology of Inflammatory Bowel Disease (IBD) has led to the development of powerful, selective, anticytokine drugs, so called biologics. Biologic therapies for IBD like Infliximab have revolutionized the treatment of patients with Crohn's disease and have begun to have an impact on therapy for refractory ulcerative colitis
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