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Changes in serum levels of lipopolysaccharides and CD26 in patients with Crohn`s disease
( Daniela Oliveira Magro ),( Paulo Gustavo Kotze ),( Carlos Augusto Real Martinez ),( Michel Gardere Camargo ),( Dioze Guadagnini ),( Antonio Ramos Calixto ),( Ana Carolina Junqueira Vasques ),( Maria 대한장연구학회 2017 Intestinal Research Vol.15 No.3
Background/Aims: Lipopolysaccharide (LPS) is a molecule formed by lipids and polysaccharides and is the major cell wall component of gram-negative bacteria. High LPS levels are known to block CD26 expression by activating Toll-like receptor 4. The aim of this study was to correlate the serum levels of LPS and CD26 in Crohn`s disease (CD) patients with serum levels of C-reactive protein (CRP), interleukins, CD activity index, and tumor necrosis factor-α (TNF-α). Methods: Serum samples were collected from 27 individuals (10 with active CD, 10 with inactive CD, and 7 controls) and the levels of LPS, CD26, TNF-α, interleukin-1β (IL-1β), IL-6, IL-17, and CRP were determined by enzyme-linked immunosorbent assay. The levels of LPS and CD26 were then tested for correlation with TNF-α, IL-1β, IL-6, IL-17, and CRP. Results: Serum levels of LPS were significantly elevated in the active CD group (P =0.003). Levels of IL-1β (P =0.002), IL-6 (P =0.003), and IL-17 (P <0.001) were lower in the CD groups. Serum TNF-α levels were increased in the active CD group. The CRP levels were elevated in the CD groups when compared to controls (P <0.001). The CD26 levels were lower in the CD groups than in the control group (P <0.001). Among the variables analyzed, there was a correlation between LPS and CRP (r=-0.53, P =0.016) in the CD groups. Conclusions: Individuals with CD exhibited higher serum levels of LPS varying from a 2- to 6-fold increase depending on disease activity, when compared with healthy controls. CD26 levels were lower in the CD groups. Both LPS and CD26 correlated with disease severity and serve as potential CD biomarkers. (Intest Res 2017;15:352-357)
Hypoalbuminemia as a risk factor for thromboembolic events in inflammatory bowel disease inpatients
Marcello Rabello Imbrizi,Daniela Oliveira Magro,Tirzah de Mendonça Lopes Secundo,Marlone Cunha-Silva,Paulo Gustavo Kotze,Ciro Garcia Montes,Jazon Romilson de Souza Almeida,Virgínia Lúcia Ribeiro Cabra 대한장연구학회 2019 Intestinal Research Vol.17 No.1
Background/Aims: Inflammatory bowel disease (IBD) are chronic entities characterized by local and systemic inflammationand may be associated with thrombosis. The aim of this study was to identify the prevalence of thromboembolic events (TEE)in hospitalized IBD patients and identify risk factors for their occurrence. Methods: This retrospective, single-center study includedpatients treated at a Brazilian IBD referral unit between 2004 and 2014. Patients hospitalized for more than 48 hoursdue to active IBD and who did not receive prophylaxis for TEE during hospitalization were included. Patients were allocated to2 groups: those with TEE up to 30 days or at the time of hospitalization (TEE-group) and patients without TEE (control-group). Clinical and laboratory characteristics were evaluated. Results: Of 53 patients evaluated, 69,8% with Crohn’s disease (CD) and30.2% with ulcerative colitis (UC). The prevalence of TEE 30 days before or during hospitalization was 15.1%, with 10.8% in CDand 25% in UC. In the TEE group, mean serum albumin was 2.06 g/dL versus 3.30 g/dL in the control group. Patients with albuminlevels below 2.95 g/dL (43.18%) had a higher risk of developing TEE (relative risk, 1.72; 95% confidence interval, 1.17–2.53)(P<0.001). Conclusions: Albumin levels were significantly lower in patients with TEE, and hypoalbuminemia was considered arisk factor for the development of TEE in this population. (Intest Res 2019;17:63-69)
Paulo Gustavo Kotze,Daniela Oliveira Magro,Barbara Saab,Mansur Paulo Saab,Lilian Vital Pinheiro,Marcia Olandoski,Maria de Lourdes Setsuko Ayrizono,Carlos Augusto Real Martinez,Claudio Saddy Rodrigues 대한장연구학회 2018 Intestinal Research Vol.16 No.1
Background/Aims: The use of anti-tumor necrosis factor (anti-TNF) agents seems to reduce surgical rates and delay surgicalprocedures in prospective trials and population-based studies in the management of Crohn’s disease (CD). This study aimedto identify whether preoperative anti-TNF agents influence the time from diagnosis to surgery. Methods: An observationalretrospective cohort study was conducted on patients with CD submitted to intestinal resections due to complications ormedical therapy failure in a period of 7 years. The patients were allocated into 2 groups according to their previous exposure toanti-TNF agents in the preoperative period. Epidemiological aspects regarding age at diagnosis, smoking, perianal disease, andpreoperative conventional therapy were considered. A Kaplan-Meier survival analysis was used to outline possible differencesbetween the groups regarding the time to surgery. Results: A total of 123 patients were included (71 and 52 with and withoutprevious exposure to biologics, respectively). The overall time to surgery was 108±6.9 months (maximum, 276 months). The survival estimation revealed no difference in the mean time to intestinal resection between the groups (99.78±10.62 months inthe patients without and 114.01±9.07 months in those with previous anti-TNF use) (log-rank P =0.35). There was no significantdifference in the time to surgery regarding perianal CD (P =0.49), smoking (P =0.63), preoperative azathioprine (P =0.073) andsteroid use (P =0.58). Conclusions: The time from diagnosis to surgery was not influenced by the preoperative use of anti-TNFtherapy in this cohort of patients.
Early Effect of 0.005% Estriol Vaginal Gel on Symptoms and Signs of Vulvovaginal Atrophy
Lázaro-Carrasco de la Fuente Jesús,Cuerva González Marcos,González Rodríguez Silvia,Delgado Marín Juan Luis,Cuevas Castillo Carmen,Nieto Magro Concepción 대한폐경학회 2022 대한폐경학회지 Vol.28 No.2
Objectives: This study aims to assess the effect of ultralow dose 0.005% estriol vaginal gel in women with genitourinary syndrome of menopause (GSM).Methods: In this prospective and multicenter single-arm study, efficacy was assessed by the evaluation of the epithelial maturation value (MV), vaginal pH, symptoms and signs of vulvovaginal atrophy. Tolerability, acceptability, and the effect on intimate relationships were also evaluated.Results: We included 35 postmenopausal women with moderate-to-severe vaginal dryness. The most bothering symptom reported was vaginal dryness. The mean increase in the MV after 7 and 14 days of treatment were 22.1 (P < 0.001) and 39.9 (P < 0.001) points, with an increase in the superficial cells of 17.7 percentage points (pp) (95% confidence interval [CI], 7.9–27.4; P < 0.001) and 41.4 pp (95% CI, 28.2–54.6; P < 0.001) observed at the timepoints. Additionally, the pH decreased by 0.6 ± 0.7 (mean ± SD) at 7 days (P < 0.0001) and by 1.1 ± 0.8 at 14 days (P < 0.0001) from a baseline mean value of 6.3 ± 0.8. The severity of vaginal dryness (range, 0 [none] to 3 [severe]) was significantly reduced by a mean of 1.4 points (P < 0.0001) at 7 days and 2 points (P < 0.0001) at 14 days. Conclusions: Ultralow dose 0.005% estriol vaginal gel produced a rapid improvement of most relevant symptoms and signs of GSM. This clinically meaningful response was observed from the initial days of treatment, confirming a fast onset and a progressive action.