1,721,061 research outputs found

    Could Pirfenidone Also be Effective in Treating Intestinal Fibrosis?

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    Fibrogenesis 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 [...]

    Review article: Biological agents in the treatment of Crohn's disease

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    The main aim of the management of Crohn's disease is to reduce inflammation. Current approaches with corticosteroids, immunosuppressive agents, mesalazine and antibiotics have limited therapeutic benefit for many patients. Considerable progress has been made with regard to our knowledge of the basic mechanisms of the disease, which is associated with immunological imbalance characterized by an excess of pro-inflammatory cytokines. Recent advances in bio-technology have led to the development of many new therapeutic agents, so-called biological agents, which selectively target single key processes involved in the pathogenesis of the disease. A growing number of biological agents are under investigation in both randomized controlled trials and uncontrolled studies. The aim of this review is to provide the clinician with an insight into the randomized controlled trials published in the literature on the use of biological agents in the treatment of Crohn's disease

    Adsorptive cytapheresis in ulcerative colitis: A non-pharmacological therapeutic approach revisited

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    Adsorptive 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

    The role on endoscopy in alcohol-related diseases

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    Alcohol, in addition to well-known damages on the liver and pancreas, produces direct and indirect injuries in the mucosa of the oesophagus, stomach, small intestine and large bowel. Different damages can be produced both when a large amount of alcohol is acutely drunk and when this is taken chronically. Almost all these lesions can be detected and treated by endoscopy as shown in the present article. When, over time, cirrhosis ensues the role of endoscopy is not different from that played with cirrhosis of different etiology. Beside hemorrhagic episodes, esophagitis, gastritis and cancer are the main alcohol related diseases that can be managed by endoscopy

    Inflammatory bowel diseases: clinical update of practical guidelines

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    Idiopathic inflammatory bowel disease (IBD) includes a collection of disorders of the gastrointestinal tract of unknown aetiology, characterized by intestinal inflammation and a chronic relapsing course associated with local and systemic complications. Traditionally, IBD comprises two prototype entities, ulcerative colitis (UC) and Crohn's disease (CD) and an intermediate variant of these diseases, indeterminate colitis which shows overlapping features of the two major forms. Over the last few years, considerable progress has been made in our knowledge of the pathogenesis of IBD, which is complex and derives from genetic, environmental and immunological interactions. The aetiology remains unclear, but it is well established that the lesions and symptoms are associated with over-production of pro-inflammatory cytokines. In this paper we briefly review the pathophysiology and the new therapeutic approaches to IBD, since from these, new achievement depends the appropriate diagnostic exams to be performed and diagnostic flow charts. © 2005 Lippincott Williams & Wilkins, Inc
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