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Am J Gastroenterol [journal]
- The Role of Thiopurines in Reducing the Need for Surgical Resection in Crohn's Disease: A Systematic Review and Meta-Analysis. [JOURNAL ARTICLE]
- Am J Gastroenterol 2013 Dec 10.
Objectives:The thiopurine (TP) analogs azathioprine and mercaptopurine have proven efficacy in inducing and maintaining clinical remission in Crohn's disease (CD). Their impact on the long-term need for surgery is uncertain since studies have reported conflicting results. The aim of this systematic review was to summarize and evaluate evidence of the published literature regarding those studies assessing the impact of TPs on the risk of first surgical resection in CD.Methods:We searched Medline, EMBASE, CINAHL, and hand searched reference lists of identified articles, without language restrictions in August 2013.Results:Seventeen retrospective observational studies (eight population based, three multicenter, and six referral center) representing 21,632 participants met our inclusion criteria. Of these 10 studies involving 12,586 participants provided data on the hazard ratio (HR) and 95% confidence intervals (CIs) evaluating use of TPs and surgical risk. The combined pooled HR of first intestinal resection with TP use was 0.59 (95% CI 0.48-0.73).Conclusions:TP use is associated with a 40% lowered risk of surgical resection in patients with CD. Despite significant reductions in rates of surgical resection in patients with CD over the last 5 decades and increasing use of TPs, a large proportion of patients with CD still require resectional surgery.Am J Gastroenterol advance online publication, 10 December 2013; doi:10.1038/ajg.2013.402.
- Necroptosis Is Active in Children With Inflammatory Bowel Disease and Contributes to Heighten Intestinal Inflammation. [JOURNAL ARTICLE]
- Am J Gastroenterol 2013 Dec 10.
OBJECTIVES:A new caspase-independent mode of programmed cell death, termed necroptosis, has recently been identified. Altered expression of molecules involved in the necroptosis pathway has been shown to trigger intestinal inflammation. The initiation of necroptosis is principally mediated by the release of receptor interacting protein 3 (RIP3) from suppression by caspase-8. Furthermore, it has been suggested that the mixed lineage kinase domain-like (MLKL) factor is an interacting target of RIP3 in active necroptosis. This study aims at investigating the occurrence of necroptosis in children with inflammatory bowel disease (IBD) and its contribution to human intestinal inflammation.METHODS:Biopsy samples were collected from the ileum and colon of 33 children with Crohn's disease, 30 with ulcerative colitis, and 20 healthy controls. Ten children with allergic colitis (AC) were used as non-IBD comparators. RIP3, caspase-8, and MLKL protein expression levels were evaluated by western blotting. The adenocarcinoma cell line HT29 was used for in vitro experiments.RESULTS:RIP3 and MLKL increased (P<0.01) in inflamed tissues of IBD and AC patients, whereas caspase-8 was reduced. No variations were observed in uninflamed tissues of patients. The relationship between RIP3 increase, active necroptosis, and intestinal inflammation was confirmed by in vitro analyses.CONCLUSIONS:We show for the first time that necroptosis is strongly associated with intestinal inflammation in children with IBD and contributes to strengthen the inflammatory process. We believe that RIP3 and MLKL could represent attractive targets for the management of human IBD.Am J Gastroenterol advance online publication, 10 December 2013; doi:10.1038/ajg.2013.403.
- Tobacco Smoking Cessation and Improved Gastroesophageal Reflux: A Prospective Population-Based Cohort Study: The HUNT Study. [JOURNAL ARTICLE]
- Am J Gastroenterol 2013 Dec 10.
OBJECTIVES:Tobacco smoking increases the risk of gastroesophageal reflux symptoms (GERS), but whether tobacco smoking cessation improves GERS is unclear. The aim of this study was to clarify if tobacco smoking cessation improves GERS.METHODS:The study was based on the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted from 1995-1997 to 2006-2009 in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported whether they had heartburn or acid regurgitation. The association between tobacco smoking cessation and improvement in GERS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by antireflux medication, and the results were adjusted for sex, age, body mass index (BMI), alcohol consumption, education, and physical exercise. Subgroup analyses were also stratified by BMI.RESULTS:Among individuals using antireflux medication at least weekly, cessation of daily tobacco smoking was associated with improvement in GERS from severe to no or minor complaints (adjusted OR 1.78; 95% CI: 1.07-2.97), compared with persistent daily smoking. This association was present among individuals within the normal range of BMI (OR 5.67; 95% CI: 1.36-23.64), but not among overweight individuals. There was no association between tobacco smoking cessation and GERS status among individuals with minor GERS or individuals using antireflux medication less than weekly.CONCLUSIONS:Tobacco smoking cessation was associated with improvement in severe GERS only in individuals of normal BMI using antireflux medication at least weekly, but not in other individual with GERS.Am J Gastroenterol advance online publication, 10 December 2013; doi:10.1038/ajg.2013.414.
- Calendar of courses, symposiums and conferences. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1940.
- The tug sign: an endoscopic feature of eosinophilic esophagitis. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1938-9.
- N-butyl-2-cyanoacrylate in gastric varices: a cause for recurrent sepsis. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1937-8.
- Genetics of Drug-Induced Hepatotoxicity Toxicity in Gilbert's Syndrome. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1936-7.
- Neurofibroma of the Esophagus Complicating Von Recklinghausen's Neurofibromatosis. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1935-6.
- No increase in epstein-barr virus viral load in a group of 30 asymptomatic patients with Crohn's disease. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1933-5.
- Western Dietary Pattern and Sedentary Life: Independent Effects of Diet and Physical Exercise Intensity on NAFLD. [Journal Article]
- Am J Gastroenterol 2013 Dec; 108(12):1932-3.