151
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Mazzoni A, Maggi L, Liotta F, Cosmi L, Annunziato F. Biological and clinical significance of T helper 17 cell plasticity. Immunology 2019; 158:287-295. [PMID: 31566706 DOI: 10.1111/imm.13124] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 12/14/2022] Open
Abstract
Mature T helper (Th) effector cells originate following antigen recognition by naive T precursors. The maturation process is accompanied by the acquisition of specific effector functions that distinguish at least three different T helper subsets: Th1, Th2 and Th17. In general, maturation of somatic cells is accompanied by terminal differentiation. However, accumulating evidence shows that effector T cells retain a certain degree of plasticity. This is especially true for Th17 cells, which have been shown to converge towards other phenotypes in response to specific microenvironmental pressure. In this review we will discuss the experimental evidence that supports the hypothesis of Th17 plasticity, with particular emphasis on the generation of Th17-derived 'non-classic' Th1 cells, and the molecular networks that control it. Moreover, we will consider why Th17 plasticity is important for host protection, but also why it can have pathogenic functions during chronic inflammation. Regarding the last point, we will discuss a possible role for biological drugs in the control of Th17 plasticity and disease course.
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Affiliation(s)
- Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Liotta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Cosmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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152
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Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, Rey-Bretal D, Lamela-Gómez I, Otero-Espinar FJ, Blanco-Méndez J, Antúnez-López JR, Pombo-Pasín M, Aguiar P, Ruibal Á, Luzardo-Álvarez A, Fernández-Ferreiro A. Evaluation of the therapeutic activity of melatonin and resveratrol in Inflammatory Bowel Disease: A longitudinal PET/CT study in an animal model. Int J Pharm 2019; 572:118713. [PMID: 31593809 DOI: 10.1016/j.ijpharm.2019.118713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022]
Abstract
Inflammatory Bowel Disease (IBD) is a group of chronic disorders of the gastrointestinal tract, which two main types are Crohn's disease and ulcerative colitis. Although conventional therapeutic strategies have demonstrated to be effective in the IBD treatment, it is necessary to incorporate novel therapeutic agents that target other mechanisms involved in the pathogenesis of the disease, such as oxidative stress. For this reason, the efficacy in vivo of two antioxidant compounds, melatonin and resveratrol, has been investigated in an animal model of TNBS (2, 4, 6-trinitrobenzenesulfonic acid) induced colitis. PET/CT (Positron emission tomography/Computer Tomography) scans were performed to assess disease activity and evaluate treatment response. SUVmax (Standardized Uptake Value) values, body weight changes and histological evaluation were used as inflammatory indices to measure the efficacy of both treatments. SUVmax values increased rapidly after induction of colitis, but after the beginning of the treatment (day 3) a statistically significant decrease was observed on days 7 and 10 in treated animals compared to the non-treated group. This remission of the disease was also confirmed by histological analysis of the colon tissue using the Nancy histological index (p value < 0.05 for differences between non-treated and both groups of treated animals). Moreover, statistical analysis showed a correlation (R2 = 65.52%) between SUVmax values and weight changes throughout the treatment. Overall, this study demonstrates the potential of resveratrol, and melatonin in lower extent, as therapeutic agents in the IBD treatment.
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Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - David Rey-Bretal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Iván Lamela-Gómez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Blanco-Méndez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - María Pombo-Pasín
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain; Tejerina Foundation, José Abascal 40, Madrid Zip Code: 28003, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela, Zip Code: 15706, Spain.
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153
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Bolin K, Hertervig E, Louis E. The Cost-effectiveness of Biological Therapy Cycles in the Management of Crohn's Disease. J Crohns Colitis 2019; 13:1323-1333. [PMID: 30893421 DOI: 10.1093/ecco-jcc/jjz063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine the cost-effectiveness of continued treatment for patients with moderate-severe Crohn's disease in clinical remission, with a combination of anti-tumour necrosis factor alpha [anti-TNFα] [infliximab] and immunomodulator therapy compared with two different withdrawal strategies: [1] withdrawal of the anti-TNFα therapy; and [2] withdrawal of the immunomodulator therapy, respectively. METHODS A decision-tree model was constructed mimicking three treatment arms: [1] continued combination therapy with infliximab and immunomodulator; [2] withdrawal of infliximab; or [3] withdrawal of the immunomodulator. Relapses in each arm are managed with treatment intensification and re-institution of the de-escalated drug according to a prespecified algorithm. State-dependent relapse risks, remission probabilities, and quality of life weights were collected from previous published studies. RESULTS Combination therapy was less costly and more efficient than the withdrawal of the immunomodulator, and more costly and more efficient than withdrawal of infliximab. Whether or not combination therapy is cost-effective, compared with the alternatives, depends primarily on current pharmaceutical prices and the willingness-to-pay per additional quality-adjusted life-year [QALY]. CONCLUSIONS Combination therapy using a combination of anti-TNFα [infliximab] and an immunomodulator is cost-effective in the treatment of Crohn's disease compared with treatment cycles in which the immunomodulator is withdrawn. Combination treatment is cost-effective compared with treatment cycles in which infliximab is withdrawn, at prices of infliximab below€192/100 mg, given a willingness-to-pay threshold at€49 020 [Sweden] per additional QALY.
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Affiliation(s)
- Kristian Bolin
- Department of Economics and Centre for Health Economics, Gothenburg University, Gothenburg, Sweden
| | - Erik Hertervig
- Department of Gastroenterology, Skane University Hospital, Lund, Sweden
| | - Edouard Louis
- Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium
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154
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Schmitt H, Neufert C, Neurath MF, Atreya R. Resolution of Crohn's disease. Semin Immunopathol 2019; 41:737-746. [PMID: 31552470 DOI: 10.1007/s00281-019-00756-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/05/2019] [Indexed: 12/19/2022]
Abstract
Crohn's disease (CD) is characterized by chronic inflammation of the gastrointestinal tract and represents one of the main inflammatory bowel disease (IBD) forms. The infiltration of immune cells into the mucosa and uncontrolled production of pro-inflammatory cytokines and other mediators trigger the chronic inflammatory reaction in the intestine [1]. The inflammatory setting consists of subsequent events that comprise an induction phase, the peak of inflammation which is subsequently followed by the resolution phase. The induction phase, which represents the first phase of inflammation, is important for the rapid and efficient activation of the immune system for sufficient host defense. The permanent sensing of exogenous or endogenous danger signals enables the fast initiation of the inflammatory reaction. The immune cell infiltrate initiates an inflammatory cascade where released lipid and protein mediators play an indispensable role [2, 3]. The last decades of research strongly suggest that resolution of inflammation is similarly a tightly coordinated and active process. The basic concept that resolution of inflammation has to be regarded as an active process has been thoroughly described by others [4-6]. The following review focuses on mechanisms, pathways, and specific mediators that are actively involved in the resolution of inflammation in CD.
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Affiliation(s)
- Heike Schmitt
- First Department of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
| | - Clemens Neufert
- First Department of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
| | - Markus F Neurath
- First Department of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
| | - Raja Atreya
- First Department of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany.
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155
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Khoshnevisan R, Nekooei-Marnany N, Klein C, Kotlarz D, Behnam M, Ostadi V, Yaran M, Rezaei A, Sherkat R. IL-12Rβ1 deficiency corresponding to concurrency of two diseases, mendelian susceptibility to mycobacterial disease and Crohn's disease. J Clin Tuberc Other Mycobact Dis 2019; 17:100123. [PMID: 31788565 PMCID: PMC6879969 DOI: 10.1016/j.jctube.2019.100123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background The interleukin-12 receptor β1 (IL-12Rβ1) deficiency is a primary immunodeficiency (PID), affecting the immunological pathway of interleukin 12/interferon- γ (IL12/IFN-γ) axis and interleukin 23 receptor (IL23R). Defect in this pathway is mainly affecting the cellular immunity-related disorders. IL-12Rβ1 is a receptor chain of both the IL-12 and the IL-23 receptors and thus, deficiency of IL-12Rβ1 abolishes both IL-12 and IL-23 signaling. Material and methods In this study, we performed whole exon sequencing and confirmatory Sanger sequencing in IL-12Rβ1. Evaluation of the IL12/IFN-γ axis was performed by assessment of patients’ whole blood cell to IL12/IFN-γ responding. Total and surface IL-12Rβ1expression was evaluated, in peripheral blood mononuclear cells (PBMCs) and T cell- derived PBMCs, and Th17 count was assessed. Results In the present study, we described a c.1791 + 2T > G mutation at a splicing site position in IL-12Rβ1, using whole exome sequencing, and confirmed with targeted Sanger sequencing in a 26- year-old patient with Mendelian susceptibility to mycobacterial disease (MSMD) and Crohn's disease (CD). Complete lack of IL-12Rβ1 protein expression was detected in patient's PBMCs, compared to the healthy control. Furthermore, no IL-12Rβ1 protein was expressed on the cell surface. Interestingly, IL-12Rβ1-mutant cells showed an impaired response to IL12, and Bacillus Calmette–Guérin stimulation, confirming that the mutation is causative in this patient. Conclusion A 3′splicing site mutation in IL12Rβ1, can be corresponding to the abolished expression of IL12Rβ1 in patients' cells, and associated with an impaired IL12-mediated signaling, which may lead not only to MSMD, but also to inflammatory bowel disease (IBD).
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Affiliation(s)
- Razieh Khoshnevisan
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nioosha Nekooei-Marnany
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Christoph Klein
- Dr. von Hauner Children's Hospital, Department of Pediatrics, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Kotlarz
- Dr. von Hauner Children's Hospital, Department of Pediatrics, University Hospital, LMU Munich, Munich, Germany
| | - Mahdieh Behnam
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihe Ostadi
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran.,Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Rezaei
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran.,Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Sherkat
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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156
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Donovan T, Crossingham I, Milan SJ, Wang R, Bradley P. Anti-IL5 therapies for chronic obstructive pulmonary disease. Hippokratia 2019. [DOI: 10.1002/14651858.cd013432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tim Donovan
- University of Cumbria; Medical and Sport Sciences; Lancaster UK
| | | | | | - Ran Wang
- Manchester University NHS Foundation Trust; Department of Respiratory Medicine; Manchester UK
| | - Patrick Bradley
- East Lancashire Hospitals NHS Trust; Blackburn Lancashire UK
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157
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Bui TM, Sumagin R. Progressing from Recurring Tissue Injury to Genomic Instability: A New Mechanism of Neutrophil Pathogenesis. DNA Cell Biol 2019; 38:747-753. [PMID: 31188020 PMCID: PMC7643757 DOI: 10.1089/dna.2019.4842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 12/11/2022] Open
Abstract
Aberrant neutrophil (PMN) infiltration of the intestinal mucosa is a hallmark of inflammatory bowel diseases, including Crohn's disease and ulcerative colitis. While the genotoxic function of PMNs and its implications in carcinogenesis have been primarily associated with oxidative stress, recent work by Butin-Israeli and colleagues has defined a novel mechanism where PMN-derived microparticles through the delivery and activity of specific miRNAs promoted formation of double-strand breaks (DSBs), and in parallel, suppressed DSB repair through the downregulation of lamin B1 and Rad51. Respective downregulation of these two proteins compromised the nuclear envelope and high-fidelity repair by homologous recombination, increasing DSB accumulation and aneuploidy. This discovery defined a novel mode of action where PMN-mediated suppression of DSB repair leading to genomic instability in the injured mucosa may facilitate progression toward colorectal cancer.
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Affiliation(s)
- Triet M. Bui
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ronen Sumagin
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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158
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Lin YS, Lin WC, Chen MJ, Wang YH, Chen C. Letter: when to withhold anti-TNF agents prior to abdominal surgery in patients with Crohn's disease-the jury might still be out. Authors' reply. Aliment Pharmacol Ther 2019; 50:465-466. [PMID: 31359483 DOI: 10.1111/apt.15398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Yang-Sheng Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medical College, New Taipei City, Taiwan
| | - Wei-Chen Lin
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medical College, New Taipei City, Taiwan.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medical College, New Taipei City, Taiwan.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Yuan-Hung Wang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chiehfeng Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Public Health, School of Medicine, College of Medicine, and Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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159
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Petit V, Parcelier A, Mathé C, Barroca V, Torres C, Lewandowski D, Ferri F, Gallouët AS, Dalloz M, Dinet O, Boschetti G, Vozenin MC, Roméo PH. TRIM33 deficiency in monocytes and macrophages impairs resolution of colonic inflammation. EBioMedicine 2019; 44:60-70. [PMID: 31130476 PMCID: PMC6604767 DOI: 10.1016/j.ebiom.2019.05.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mature myeloid cells play a crucial role in Crohn's disease (CD) but the molecular players that regulate their functions in CD are not fully characterized. We and others have shown that TRIM33 is involved in the innate immune response and in the inflammatory response but TRIM33 role in intestinal inflammation is not known. In this study, we investigated the role of TRIM33 in myeloid cells during dextran sulfate sodium (DSS)-induced colitis. METHODS We study the role of TRIM33 during DSS-induced colitis which mimics intestinal inflammation using mice deleted for Trim33 only in mature myeloid cells (Trim33-/- mice) FINDINGS: We first show that Trim33 mRNA level is decreased in CD patient's blood monocytes suggesting a role of TRIM33 in CD. Using Trim33-/- mice, we show that these mice display an impaired resolution of colonic inflammation with an increased number of blood and colon monocytes and a decreased number of colonic macrophages. Trim33-/- monocytes are less competent for recruitment and macrophage differentiation. Finally, during resolution of inflammation, Trim33-/- colonic macrophages display an impaired M1/M2 switch and express a low level of membrane-bound TNF that is associated with an increased number of colonic neutrophils. INTERPRETATION Our study shows an important role of TRIM33 in monocytes/macrophages during DSS-induced colitis and suggests that the decreased expression of TRIM33 in CD patient's blood monocytes might not be a consequence but might be involved in CD progression. FUND: La Ligue contre le Cancer (équipe labelisée), INSERM, CEA, Université Paris-Diderot, Université Paris-Sud.
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Affiliation(s)
- Vanessa Petit
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France.
| | - Aude Parcelier
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France; Yposkei (Genethon), 91200 Corbeil-Essonnes, France
| | - Cecile Mathé
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France
| | - Vilma Barroca
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France
| | - Claire Torres
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France
| | - Daniel Lewandowski
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France
| | - Federica Ferri
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France
| | - Anne-Sophie Gallouët
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France; CEA/DRF/JACOB/IDMIT, 92265 Fontenay-aux-Roses Cedex, France
| | - Marion Dalloz
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France; Servier, Oncology, 78290 Croissy, France
| | - Océane Dinet
- Hospices Civils de Lyon, Department of Gastroenterology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France; CIRI, International Center for Infectiology Research, INSERM U1111, Lyon, France
| | - Gilles Boschetti
- Hospices Civils de Lyon, Department of Gastroenterology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France; CIRI, International Center for Infectiology Research, INSERM U1111, Lyon, France
| | - Marie-Catherine Vozenin
- Radio-Oncology Research Laboratory, Vaudois University Hospital Centre (CHUV), Epalinges, Switzerland
| | - Paul-Henri Roméo
- CEA/DRF/IBFJ/iRCM/LRTS, 92265 Fontenay-aux-Roses Cedex, France; Inserm U967, 92265 Fontenay-aux-Roses Cedex, France; Université Paris-Diderot, Paris 7, France; Université Paris-Sud, Paris 11, France; Equipe labellisée Ligue contre le Cancer, France.
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160
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Harris RJ, McDonnell M, Young D, Bettey M, Downey L, Pigott L, Felwick R, Gwiggner M, Cummings JRF. Early real-world effectiveness of ustekinumab for Crohn's disease. Frontline Gastroenterol 2019; 11:111-116. [PMID: 32133109 PMCID: PMC7043072 DOI: 10.1136/flgastro-2019-101237] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To understand the effectiveness of ustekinumab in treating Crohn's disease (CD) in a UK real-world setting. DESIGN Retrospective cohort study using prospectively maintained clinical records. SETTING Single UK inflammatory bowel disease centre. PATIENTS Adult patients with an established diagnosis of CD prescribed ustekinumab outside of clinical trials at University Hospital Southampton (UHS). INTERVENTIONS Ustekinumab, a monoclonal antibody to the shared p40 subunit of interleukin (IL) 12 and IL-23 as part of routine clinical care. MAIN OUTCOME MEASURES Effectiveness as measured by an improvement in physician's global assessment, drug persistence and improvement in biomarkers (C-reactive protein (CRP), albumin and calprotectin). RESULTS 84 patients were included, 72 had a postinduction review and 49 had 1-year data. At postinduction clinical review, clinical response occurred in 53% of patients and clinical remission occurred in 8%. For patients on ustekinumab at 1 year, clinical response occurred in 71% and remission in 14%. Adverse events included four patients with infections requiring admission, one drug-related rash, five CD surgeries and two CD exacerbations. CONCLUSIONS Ustekinumab was well tolerated in a complex UK CD population and demonstrated benefit to patients in terms of clinical response and improvement of biomarkers and with some patients attaining clinical remission. No unexpected safety signals were seen.
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Affiliation(s)
- Richard James Harris
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Martin McDonnell
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David Young
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Marion Bettey
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Louise Downey
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lucinda Pigott
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard Felwick
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Markus Gwiggner
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J R Fraser Cummings
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK,Faculty of Medicine, University of Southampton, Southampton, UK
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A SPECIAL MEETING REVIEW EDITION: Highlights in Inflammatory Bowel Disease From the 14th Congress of ECCO: A Review of Selected Presentations From the 14th Congress of the European Crohn's and Colitis Organisation (ECCO) • March 6-9, 2019 • Copenhagen, Denmark Special Reporting on:• VARSITY: A Double-Blind, Double-Dummy, Randomized Controlled Trial of Vedolizumab Versus Adalimumab in Patients With Active Ulcerative Colitis• Analyses of Data From the VISIBLE 1 and 2 Trials: Vedolizumab in Patients With Ulcerative Colitis or Crohn's Disease• Improved Endoscopic Outcomes and Mucosal Healing of Upadacitinib as an Induction Therapy in Adults With Moderately to Severely Active Ulcerative Colitis: Data From the U-ACHIEVE Study• Long-Term Safety of Vedolizumab in Ulcerative Colitis and Crohn's Disease: Final Results From the GEMINI LTS Study• Pediatric Crohn's Disease Adalimumab Level-Based Optimization Treatment (PAILOT) Randomized Controlled Trial• Maintenance Treatment With Mirikizumab, a P19-Directed IL-23 Antibody: 52-Week Results in Patients With Moderately to Severely Active Ulcerative Colitis• Real-World Effectiveness and Safety of Vedolizumab and Anti-TNF Therapy in Biologic-Naive Patients With Ulcerative Colitis or Crohn's Disease: Results From the EVOLVE Study• A Randomized, Multicenter, Double-Blind, Placebo-Controlled Study of a Targeted-Release Oral Cyclosporine Formulation in the Treatment of Mild to Moderate Ulcerative Colitis: Efficacy Results• Real-World Analyses of Patients With IBD Treated With Vedolizumab PLUS Meeting Abstract Summaries With Expert Commentary by: Edward V. Loftus Jr, MDProfessor of MedicineDivision of Gastroenterology and HepatologyMayo ClinicRochester, Minnesota. Gastroenterol Hepatol (N Y) 2019; 15:1-24. [PMID: 31632213 PMCID: PMC6794565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Abstract
PURPOSE OF REVIEW Crohn's disease management has changed significantly with increasing use of biologics. We review the recent literature on the clinical management of Crohn's disease and new approaches in selecting and optimizing therapy. RECENT FINDINGS Recent studies have addressed the efficacy of proactive anti-TNFα trough level monitoring, the efficacy of biosimilars, and the efficacy and immunogenicity of newer biologics including anti-integrin therapy and anti-IL12/23 therapy. Optimizing anti-TNFα therapy according to trough concentrations correlates with improved remission rates. Patients can be switched from the reference drug to a biosimilar, or vice versa, without a measurable change in efficacy, safety, or immunogenicity. Immunomodulators are effective in decreasing immunogenicity and boosting anti-TNFα drug level. The anti-integrin and anti-IL12/23 therapies are effective as induction and maintenance therapy with low immunogenicity and excellent safety profiles. Patients at high risk for post-operative recurrence should be started on a biologic therapy within 4 weeks post-op. Multiple biologic therapies are currently available for treatment of Crohn's disease including anti-TNFα therapy, anti-integrin therapy, and anti-IL12/23 therapy. The choice of first-line therapy should be based on individual risk-benefit analysis, route of administration, and patient preference. Patient with inadequate response should have their trough level checked and therapy optimized. Therapeutic prophylaxis for post-operative recurrence should be based on patient's risk factors for recurrence.
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Affiliation(s)
- Thomas X Lu
- Section of Gastroenterology, Hepatology and Nutrition, Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Russell D Cohen
- Section of Gastroenterology, Hepatology and Nutrition, Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, 60637, USA.
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Richter F, Seifert O, Herrmann A, Pfizenmaier K, Kontermann RE. Improved monovalent TNF receptor 1-selective inhibitor with novel heterodimerizing Fc. MAbs 2019; 11:653-665. [PMID: 30929560 DOI: 10.1080/19420862.2019.1596512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The development of alternative therapeutic strategies to tumor necrosis factor (TNF)-blocking antibodies for the treatment of inflammatory diseases has generated increasing interest. In particular, selective inhibition of TNF receptor 1 (TNFR1) promises a more precise intervention, tackling only the pro-inflammatory responses mediated by TNF while leaving regenerative and pro-survival signals transduced by TNFR2 untouched. We recently generated a monovalent anti-TNFR1 antibody fragment (Fab 13.7) as an efficient inhibitor of TNFR1. To improve the pharmacokinetic properties of Fab 13.7, the variable domains of the heavy and light chains were fused to the N-termini of newly generated heterodimerizing Fc chains. This novel Fc heterodimerization technology, designated "Fc-one/kappa" (Fc1κ) is based on interspersed constant Ig domains substituting the CH3 domains of a γ1 Fc. The interspersed immunoglobulin (Ig) domains originate from the per se heterodimerizing constant CH1 and CLκ domains and contain sequence stretches of an IgG1 CH3 domain, destined to enable interaction with the neonatal Fc receptor, and thus promote extended serum half-life. The resulting monovalent Fv-Fc1κ fusion protein (Atrosimab) retained strong binding to TNFR1 as determined by enzyme-linked immunosorbent assay and quartz crystal microbalance, and potently inhibited TNF-induced activation of TNFR1. Atrosimab lacks agonistic activity for TNFR1 on its own and in the presence of anti-human IgG antibodies and displays clearly improved pharmacokinetic properties.
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Affiliation(s)
- Fabian Richter
- a Institute of Cell Biology and Immunology , University of Stuttgart , Stuttgart , Germany.,b Stuttgart Research Center Systems Biology , University of Stuttgart , Stuttgart , Germany
| | - Oliver Seifert
- a Institute of Cell Biology and Immunology , University of Stuttgart , Stuttgart , Germany.,b Stuttgart Research Center Systems Biology , University of Stuttgart , Stuttgart , Germany
| | | | - Klaus Pfizenmaier
- a Institute of Cell Biology and Immunology , University of Stuttgart , Stuttgart , Germany.,b Stuttgart Research Center Systems Biology , University of Stuttgart , Stuttgart , Germany
| | - Roland E Kontermann
- a Institute of Cell Biology and Immunology , University of Stuttgart , Stuttgart , Germany.,b Stuttgart Research Center Systems Biology , University of Stuttgart , Stuttgart , Germany
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Gordon N, Sebastian S. Real-World Success of Biologic Therapy in IBD: No More Reasons to Be Anti Antibody. Dig Dis Sci 2019; 64:614-615. [PMID: 30478765 DOI: 10.1007/s10620-018-5385-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Neil Gordon
- IBD Unit, Department of Gastroenterology, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Shaji Sebastian
- IBD Unit, Department of Gastroenterology, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK. .,Hull York Medical School, Hull, UK.
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Kyriakou G, Gkermpesi M, Thomopoulos K, Marangos M, Georgiou S. Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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