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Zagórowicz E, Cichoż-Lach H, Kopertowska-Majchrzak M, Eder P, Stawczyk-Eder K, Talar-Wojnarowska R, Zatorski H, Solarska-Półchłopek A, Filip R, Janiak M, Skrobot K, Kłopocka M, Liebert A, Kaczka A, Wojciechowski K, Drygała S, Michalak A. Real-world effectiveness and safety of vedolizumab induction therapy for ulcerative colitis: A prospective nationwide Polish observational study. ADV CLIN EXP MED 2024; 33:69-77. [PMID: 37166016 DOI: 10.17219/acem/162969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/17/2022] [Accepted: 04/03/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Vedolizumab is recommended as a first-line biological treatment, along with other biological drugs, in ulcerative colitis (UC) patients in whom conventional therapy failed and as a second-line biological treatment following a failure of a tumor necrosis factor alpha (TNF-α) antagonist. OBJECTIVES We aimed to assess the real-world effectiveness and safety of vedolizumab induction therapy in UC patients treated in the scope of the National Drug Program (NDP) in Poland. MATERIAL AND METHODS The endpoints were the proportions of patients who reached clinical response, clinical remission and mucosal healing at week 14. Partial Mayo scores, Mayo subscores and C-reactive protein (CRP) levels were also evaluated. RESULTS Our study population consisted of 100 patients (55 biologic-naïve and 45 biologic-exposed). The median total Mayo score at baseline was 10 (interquartile range (IQR): 9-11), and 52 patients (52%) had extensive colitis. The clinical response at week 14 was achieved in 83 (83%) and clinical remission in 24 (24%) cases. Mucosal healing was observed in 56 (62%) patients at week 14. In patients with prior failure of biologic treatment (n = 25), 17 (68%) responded to vedolizumab treatment. A decrease in the median CRP level (from 3.7 mg/L to 2.6 mg/L) and the median total Mayo score (from 10 to 4) was observed. No new safety concerns were recorded and no patients discontinued the treatment due to adverse events (AEs). CONCLUSIONS Vedolizumab was effective and safe as induction therapy for UC in a Polish real-world population including patients with severely active UC and a low number of patients with prior biological treatment failures.
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Affiliation(s)
- Edyta Zagórowicz
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | | | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, H. Święcicki University Hospital, Poznan University of Medical Sciences, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, H. Święcicki University Hospital, Poznan University of Medical Sciences, Poland
| | | | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Poland
| | - Anna Solarska-Półchłopek
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Rafał Filip
- Department of Gastroenterology with Inflammatory Bowel Disease Unit, Clinical Hospital No. 2, Rzeszów, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology, Medical University of Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology, Medical University of Gdańsk, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, Military Medical Academy Memorial Teaching Hospital - Central Veterans' Hospital, Łódź, Poland
| | | | - Szymon Drygała
- Medical Affairs, Takeda Pharma sp. z o.o., Warsaw, Poland
| | - Agata Michalak
- Department of Gastroenterology, Medical University of Lublin, Poland
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Nagy R, Ocskay K, Sipos Z, Szentesi A, Vincze Á, Czakó L, Izbéki F, Shirinskaya NV, Poluektov VL, Zolotov AN, Zhu Y, Xia L, He W, Sutton R, Szatmary P, Mukherjee R, Burridge IS, Wauchope E, Francisco E, Aparicio D, Pinto B, Gomes A, Nunes V, Tantau VM, Sagau ED, Tantau AI, Suceveanu AI, Tocia C, Dumitru A, Pando E, Alberti P, Cirera A, Molero X, Lee HS, Jung MK, Kim EJ, Lee S, Rebollo MLR, Nistal RB, Santervas SI, Lesko D, Soltes M, Radonak J, Zatorski H, Małecka-Panas E, Fabisiak A, Yaroslav MS, Mykhailo VM, Olekcandr AT, Barauskas G, Simanaitis V, Ignatavicius P, Jinga M, Balaban VD, Patoni C, Gong L, Song K, Li Y, Gonçalves TC, Freitas M, Macedo V, Vornhuelz M, Klauss S, Beyer G, Koksal AS, Tozlu M, Eminler AT, Monclús NT, Comas EP, Oballe JAR, Nawacki Ł, Głuszek S, Rama-Fernández A, Galego M, de la Iglesia D, Aykut UE, Duman DG, Aslan R, Gherbon A, Deng L, Huang W, Xia Q, Poropat G, Radovan A, Vranić L, Ricci C, Ingaldi C, Casadei R, Negoi I, Ciubotaru C, Iordache FM, Constantinescu G, Sandru V, Altintas E, Balci HR, Constantino J, Aveiro D, Pereira J, Gunay S, Misirlioglu Sucan S, Dronov O, Kovalska I, Bush N, Rana SS, Chooklin S, Chuklin S, Saizu IA, Gheorghe C, Göltl P, Hirth M, Mateescu RB, Papuc G, Minkov GA, Enchev ET, Mastrangelo L, Jovine E, Chen W, Zhu Q, Gąsiorowska A, Fabisiak N, Bezmarevic M, Litvin A, Mottes MC, Choi EK, Bánovčin P, Nosáková L, Kovacheva-Slavova MD, Kchaou A, Tlili A, Marino MV, Kusnierz K, Mickevicius A, Hollenbach M, Molcan P, Ioannidis O, Tokarev MV, Ince AT, Semenenko IA, Galeev S, Ramírez-Maldonado E, Sallinen V, Pencik P, Bajor J, Sarlós P, Hágendorn R, Gódi S, Szabó I, Czimmer J, Pár G, Illés A, Faluhelyi N, Kanizsai P, Nagy T, Mikó A, Németh B, Hamvas J, Bod B, Varga M, Török I, Novák J, Patai Á, Sümegi J, Góg C, Papp M, Erőss B, Váncsa S, Teutsch B, Márta K, Hegyi PJ, Tornai T, Lázár B, Hussein T, Tarján D, Lipp M, Kovács B, Urbán O, Fürst E, Tari E, Kocsis I, Maurovich-Horvát P, Tihanyi B, Eperjesi O, Kormos Z, Deák PÁ, Párniczky A, Hegyi P. Discharge protocol in acute pancreatitis: an international survey and cohort analysis. Sci Rep 2023; 13:22109. [PMID: 38092809 PMCID: PMC10719286 DOI: 10.1038/s41598-023-48480-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.
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Affiliation(s)
- Rita Nagy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | | | - Zoltán Sipos
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - László Czakó
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Ferenc Izbéki
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Natalia V Shirinskaya
- Omsk State Medical Information-Analytical Centre, Omsk State Medical University, Omsk, Russia
| | | | - Alexandr N Zolotov
- Department of Pathophysiology, Clinical Pathophysiology, Omsk State Medical University, Omsk, Russia
| | - Yin Zhu
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liang Xia
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wenhua He
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Robert Sutton
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Peter Szatmary
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rajarshi Mukherjee
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Emma Wauchope
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Elsa Francisco
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - David Aparicio
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Bruno Pinto
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - António Gomes
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Vitor Nunes
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Vasile Marcel Tantau
- "Octavin Fodor" Institute of Gastroenterology and Hepartology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Emanuela Denisa Sagau
- "Octavin Fodor" Institute of Gastroenterology and Hepartology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Alina Ioana Tantau
- Gastroenterology Department, 4th Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | | | - Cristina Tocia
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Andrei Dumitru
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Elizabeth Pando
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Piero Alberti
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Arturo Cirera
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Molero
- Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron, Institut de Recerca, Universitat Autònoma de Barcelona, CIBEREHD, Barcelona, Spain
| | - Hong Sik Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Min Kyu Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Eui Joo Kim
- Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Sanghyub Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Reyes Busta Nistal
- Servicio de Aparato Digestivo Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | | | - Dusan Lesko
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Marek Soltes
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Jozef Radonak
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Adam Fabisiak
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - M Susak Yaroslav
- Department of Surgery With a Course of Emergency and Vascular Surgery, Bogomolet National Medical University, Kiev, Ukraine
| | - V Maksymenko Mykhailo
- Department of Surgery With a Course of Emergency and Vascular Surgery, Bogomolet National Medical University, Kiev, Ukraine
| | | | - Giedrius Barauskas
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vytautas Simanaitis
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Mariana Jinga
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Cristina Patoni
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Liang Gong
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Kai Song
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Yunlong Li
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - T Cúrdia Gonçalves
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga/Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Marta Freitas
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Vítor Macedo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga/Guimarães, Portugal
| | | | - Sarah Klauss
- LMU University Hospital, LMU Munich, Munich, Germany
| | - Georg Beyer
- LMU University Hospital, LMU Munich, Munich, Germany
| | - Aydin Seref Koksal
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mukaddes Tozlu
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ahmet Tarik Eminler
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nuria Torres Monclús
- University Hospital Arnau de Vilanova, Hospital University Santa Maria, Lleida, Spain
| | - Eva Pijoan Comas
- University Hospital Arnau de Vilanova, Hospital University Santa Maria, Lleida, Spain
| | | | - Łukasz Nawacki
- Collegium Medicum, The Jan Kochanowski University in Kielce, Kielce, Poland
| | - Stanisław Głuszek
- Collegium Medicum, The Jan Kochanowski University in Kielce, Kielce, Poland
| | - Alberto Rama-Fernández
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Marco Galego
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Daniel de la Iglesia
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Umut Emre Aykut
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Deniz Güney Duman
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Rahmi Aslan
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Adriana Gherbon
- Discipline of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases and Systemic Rheumatology, Victor Babeş University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Lihui Deng
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Huang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Goran Poropat
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Anja Radovan
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Luka Vranić
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Claudio Ricci
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Carlo Ingaldi
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Riccardo Casadei
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ionut Negoi
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Cezar Ciubotaru
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Florin Mihail Iordache
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Gabriel Constantinescu
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Vasile Sandru
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Engin Altintas
- Gastroenterology Department, Faculty of Medicine, Mersin University, Yenisehir/Mersin, Turkey
| | - Hatice Rizaoglu Balci
- Gastroenterology Department, Faculty of Medicine, Mersin University, Yenisehir/Mersin, Turkey
| | - Júlio Constantino
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Débora Aveiro
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Jorge Pereira
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Suleyman Gunay
- İzmir Katip Çelebi University Atatürk Training and Research Hospital, Karabaglar/Izmir, Turkey
| | - Seda Misirlioglu Sucan
- İzmir Katip Çelebi University Atatürk Training and Research Hospital, Karabaglar/Izmir, Turkey
| | - Oleksiy Dronov
- General Surgery #1, Bogomolets National Medical University, Kiev, Ukraine
| | - Inna Kovalska
- General Surgery #1, Bogomolets National Medical University, Kiev, Ukraine
| | - Nikhil Bush
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | | | | | - Cristian Gheorghe
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Institute Fundeni, Bucharest, Romania
| | - Philipp Göltl
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Hirth
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Radu Bogdan Mateescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Gastroenterology Department, Colentina Clinical Hospital Bucharest, Bucharest, Romania
| | - Geanina Papuc
- Gastroenterology Department, Colentina Clinical Hospital Bucharest, Bucharest, Romania
| | | | | | - Laura Mastrangelo
- Department of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, Bologna, Italy
| | - Elio Jovine
- Department of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, Bologna, Italy
| | - Weiwei Chen
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Quping Zhu
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Anita Gąsiorowska
- Department of Gastroenterology Medical, University of Lodz, Lodz, Poland
| | - Natalia Fabisiak
- Department of Gastroenterology Medical, University of Lodz, Lodz, Poland
| | - Mihailo Bezmarevic
- Department for Hepatobiliary and Pancreatic Surgery, Clinic for General Surgery, Military Medical Academy, University of Defense, Belgrade, Serbia
| | | | - Martina Cattani Mottes
- Department of Medicine, Gastroenterology, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy
| | - Eun Kwang Choi
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, South Korea
| | - Peter Bánovčin
- Clinic of Internal Medicine - Gastroenterology, JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava, Bratislava, Slovakia
| | - Lenka Nosáková
- Clinic of Internal Medicine - Gastroenterology, JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava, Bratislava, Slovakia
| | | | - Ali Kchaou
- Habib Bourguiba University Hospital, Sfax, Tunisia
| | | | - Marco V Marino
- General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | | | - Marcus Hollenbach
- Division of Gastroenterology, University of Leipzig Medical Center, Leipzig, Germany
| | - Pavol Molcan
- Hepatology and Gastroenterology Department of Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Orestis Ioannidis
- 4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", Thessaloniki, Greece
| | - Mark Valerievich Tokarev
- Sklifosovsky Institute for Clinical Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ali Tüzün Ince
- Hospital of Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
| | | | - Shamil Galeev
- Saint Luke Clinical Hospital, St. Petersburg, Russia
| | | | - Ville Sallinen
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Petr Pencik
- Centrum péče o zažívací trakt, Vítkovická Nemocnice a.s., Ostrava, Czech Republic
| | - Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Patricia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Roland Hágendorn
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Gódi
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Imre Szabó
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Czimmer
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriella Pár
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Illés
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nándor Faluhelyi
- Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Kanizsai
- Department of Emergency Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Nagy
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Németh
- Department of Medicine, University of Szeged, Szeged, Hungary
| | | | | | - Márta Varga
- Department of Gastroenterology, BMKK Dr Rethy Pal Hospital, Békéscsaba, Hungary
| | - Imola Török
- County Emergency Clinical Hospital of Târgu Mures - Gastroenterology Clinic and University of Medicine, Pharmacy, Sciences and Technology "George Emil Palade", Targu Mures, Romania
| | - János Novák
- Pándy Kálmán Hospital of Békés County, Gyula, Hungary
| | - Árpád Patai
- Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - János Sümegi
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Csaba Góg
- Healthcare Center of County Csongrád, Makó, Hungary
| | - Mária Papp
- Department of Gastroenterology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Katalin Márta
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Jenő Hegyi
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tamás Tornai
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Balázs Lázár
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tamás Hussein
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Dorottya Tarján
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Mónika Lipp
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Beáta Kovács
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Orsolya Urbán
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Emese Fürst
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Edina Tari
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Ibolya Kocsis
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvát
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Balázs Tihanyi
- Department for Surgery, Hungarian Defence Forces - Medical Centre, Budapest, Hungary
| | - Orsolya Eperjesi
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Zita Kormos
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Pál Ákos Deák
- Medical Imaging Centre, Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Andrea Párniczky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary.
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation, University of Szeged, Szeged, Hungary.
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3
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Eder P, Kłopocka M, Cichoż-Lach H, Talar-Wojnarowska R, Kopertowska-Majchrzak M, Michalak A, Filip R, Waszak K, Stawczyk-Eder K, Janiak M, Skrobot K, Liebert A, Zatorski H, Solarska-Półchłopek A, Krogulecki M, Pękała A, Poniewierka E, Smoła I, Kaczka A, Wojciechowski K, Drygała S, Zagórowicz E. Real-world outcomes of 54-week vedolizumab therapy and response durability after treatment discontinuation in ulcerative colitis: results from a multicenter prospective POLONEZ study. Therap Adv Gastroenterol 2023; 16:17562848231151295. [PMID: 36818601 PMCID: PMC9932778 DOI: 10.1177/17562848231151295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/27/2022] [Indexed: 02/17/2023] Open
Abstract
Background Vedolizumab is a gut-selective anti-lymphocyte trafficking agent used to treat ulcerative colitis (UC) and Crohn's disease. Objectives We aimed to evaluate the effectiveness, safety, and durability of the therapeutic effect of vedolizumab after treatment discontinuation in a real-world cohort of patients with UC treated in Poland. Design This was a multicenter, prospective study involving patients with moderate to severely active UC from 12 centers in Poland who qualified for reimbursed treatment with vedolizumab between February and November 2019. Methods The primary endpoints were clinical response (⩾2-point improvement from baseline on partial Mayo score) and clinical remission (partial Mayo score 0-1), including steroid-free remission, at week 54. Other outcomes included response durability at 26 weeks after treatment discontinuation, identification of predictors of response and remission, and safety assessment. Results In all, 100 patients with UC were enrolled (55 biologic naïve and 45 biologic exposed). At baseline, 68% of patients were on corticosteroids and 45% on immunomodulators. Clinical response was observed in 62% of patients, clinical remission in 50%, and steroid-free remission in 42.6% at week 54. Within 26 weeks after treatment discontinuation, 37% of patients who maintained response by week 54 relapsed. The decreased number of liquid stools and rectal bleeding and endoscopic response at week 14 were predictive factors for response at week 54. Time from diagnosis ranging 2-5 years, decreased stool frequency, and non-concomitant use of corticosteroids at baseline and at week 14 were predictive factors for remission at week 54. Partial Mayo score < 3 with no subscale score > 1 at week 54 was a predictive factor for durable response after treatment discontinuation. The rate of serious adverse events related to treatment was 3.63 per 100 patient-years. Conclusion Vedolizumab is effective and safe in UC treatment in Polish patients. However, the relapse rate after the treatment cessation was high. Registration ENCePP (EUPAS34119).
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Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Halina Cichoż-Lach
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | | | | | - Agata Michalak
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | - Rafał Filip
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology,
Medical University of Gdansk, Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology,
Medical University of Gdansk, Gdańsk, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases,
Medical University of Lodz, Łódź, Poland
| | - Anna Solarska-Półchłopek
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| | - Michał Krogulecki
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Anna Pękała
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Elżbieta Poniewierka
- Department of Gastroenterology and Hepatology,
Wroclaw Medical University, Wrocław, Poland
| | - Izabela Smoła
- Department of Gastroenterology and Hepatology,
Wroclaw Medical University, Wrocław, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy - Central Veterans’
Hospital, Łódź, Poland
| | | | | | - Edyta Zagórowicz
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
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4
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Kral J, Nakov R, Lanska V, Barberio B, Benech N, Blesl A, Brunet E, Capela T, Derikx L, Dragoni G, Eek A, Frias-Gomes C, Gîlcă-Blanariu GE, Gilroy L, Harvey P, Kagramanova A, Kani H, Konikoff T, Lessing M, Madsen G, Maksimaityte V, Miasnikova M, Mikolašević I, Milivojevic V, Noviello D, Oliinyk D, Patai A, Pisani A, Protopapas A, Rodríguez-Lago I, Schreiner P, Skuja V, Tran F, Truyens M, Włodarczyk M, Zatorski H, Verstockt B, Segal JP. Significant differences in IBD care and education across Europe: results of the pan-European VIPER survey. Dig Dis 2022; 41:387-395. [PMID: 36412565 DOI: 10.1159/000528070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) care and education might differ around Europe. Therefore, we conducted this European Variation In IBD PracticE suRvey (VIPER) to investigate potential differences between countries. METHODS This trainee-initiated survey, run through SurveyMonkey®, consisted of 47 questions inquiring basic demographics, IBD training, and clinical care. Results were compared according to gross domestic product (GDP) per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank). RESULTS The online survey was completed by 1285 participants from 40 European countries, with a majority of specialists (65.3%) working in academic institutions (50.4%). Significant differences in IBD-specific training (55.9% vs. 38.4%), as well as availability of IBD units (58.4% vs. 39.7%) and multidisciplinary meetings (73.2% vs. 40.1%) were observed between respondees from high and low GDP countries (p<0.0001). In high GDP countries, IBD nurses are more common (85.9% vs. 36.0%), also mirrored by more nurse-led IBD clinics (40.6% vs. 13.7%; p<0.0001). IBD dieticians (33.4% vs. 16.5%) and psychologists (16.8% vs. 7.5%) are mainly present in high GDP countries (p<0.0001). In the current COVID era, telemedicine is available in 73.2% vs. 54.1% of the high/low GDP countries respectively (p<0.0001). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly. CONCLUSION Much variability in IBD practice exists across Europe, with marked differences between high vs. low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardize IBD care and training across Europe.
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5
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Winter K, Dzieniecka M, Strzelczyk J, Wągrowska-Danilewicz M, Danilewicz M, Zatorski H, Małecka-Wojciesko E. Hedgehog Signaling Pathway Proteins in Prognosis of Pancreatic Ductal Adenocarcinoma and Its Differentiation From Chronic Pancreatitis. Pancreas 2022; 51:219-227. [PMID: 35584378 DOI: 10.1097/mpa.0000000000002001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The Hedgehog signaling pathway (Hh) probably plays a role in development and progression of pancreatic ductal adenocarcinoma (PDAC). METHODS In our study, 114 patients (83 with PDAC and 31 with chronic pancreatitis [CP]) after pancreatic surgery were enrolled. The immunoexpression of Sonic hedgehog (Shh), Smoothened (Smo), and Glioblastoma transcription factor 1 (Gli1) and Ki-67 were detected in tissue specimens. RESULTS Mean (standard deviation) immunoexpression of all Hh pathway molecules was significantly higher in PDAC than in CP patients: Shh, 2.24 (0.57) versus 1.17 (0.25) (P < 0.01); Smo, 2.62 (0.34) versus 1.21 (0.23) (P < 0.01); and Gli1, 1.74 (0.74) versus 1.15 (0.72) (P < 0.01). Patients with a lower expression level (z score <0) of Shh and Ki-67 have longer overall survival when compared with z score >0 (15.97 vs 8.53 months [P = 0.0087] and 15.20 vs 5.53 months [P = 0.0004], respectively). In addition, Shh sensitivity in PDAC detection was 84.3%; specificity, 93.5%; positive predictive value, 97.2%; and negative predictive value, 69%. CONCLUSIONS Our results suggest the prognostic role of the Hh pathway in PDAC and a role in the differential diagnosis with CP.
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Affiliation(s)
- Katarzyna Winter
- From the Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | | | | | | | - Marian Danilewicz
- Nephropathology, Division of Morphometry, Medical University of Lodz, Lodz, Poland
| | - Hubert Zatorski
- From the Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Ewa Małecka-Wojciesko
- From the Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
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6
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Ocskay K, Juhász MF, Farkas N, Zádori N, Szakó L, Szakács Z, Szentesi A, Erőss B, Miklós E, Zemplényi A, Birkás B, Csathó Á, Hartung I, Nagy T, Czopf L, Izbéki F, Gajdán L, Papp M, Czakó L, Illés D, Marino MV, Mirabella A, Małecka-Panas E, Zatorski H, Susak Y, Opalchuk K, Capurso G, Apadula L, Gheorghe C, Saizu IA, Petersen OH, de-Madaria E, Rosendahl J, Párniczky A, Hegyi P. Recurrent acute pancreatitis prevention by the elimination of alcohol and ciga rette smoking (REAPPEAR): protocol of a randomised controlled trial and a cohort study. BMJ Open 2022; 12:e050821. [PMID: 34983758 PMCID: PMC8728419 DOI: 10.1136/bmjopen-2021-050821] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/OBJECTIVES Acute recurrent pancreatitis (ARP) due to alcohol and/or tobacco abuse is a preventable disease which lowers quality of life and can lead to chronic pancreatitis. The REAPPEAR study aims to investigate whether a combined patient education and cessation programme for smoking and alcohol prevents ARP. METHODS AND ANALYSIS The REAPPEAR study consists of an international multicentre randomised controlled trial (REAPPEAR-T) testing the efficacy of a cessation programme on alcohol and smoking and a prospective cohort study (REAPPEAR-C) assessing the effects of change in alcohol consumption and smoking (irrespective of intervention). Daily smoker patients hospitalised with alcohol-induced acute pancreatitis (AP) will be enrolled. All patients will receive a standard intervention priorly to encourage alcohol and smoking cessation. Participants will be subjected to laboratory testing, measurement of blood pressure and body mass index and will provide blood, hair and urine samples for later biomarker analysis. Addiction, motivation to change, socioeconomic status and quality of life will be evaluated with questionnaires. In the trial, patients will be randomised either to the cessation programme with 3-monthly visits or to the control group with annual visits. Participants of the cessation programme will receive a brief intervention at every visit with direct feedback on their alcohol consumption based on laboratory results. The primary endpoint will be the composite of 2-year all-cause recurrence rate of AP and/or 2-year all-cause mortality. The cost-effectiveness of the cessation programme will be evaluated. An estimated 182 participants will be enrolled per group to the REAPPEAR-T with further enrolment to the cohort. ETHICS AND DISSEMINATION The study was approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (40394-10/2020/EÜIG), all local ethical approvals are in place. Results will be disseminated at conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04647097.
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Affiliation(s)
- Klementina Ocskay
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Márk Félix Juhász
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Medical School, Institute of Bioanalysis, University of Pécs, Pécs, Hungary
| | - Noémi Zádori
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Emőke Miklós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Antal Zemplényi
- Faculty of Pharmacy, Division of Pharmacoeconomics, University of Pécs, Pécs, Hungary
- Center for Health Technology Assessment, University of Pécs, Pécs, Hungary
| | - Béla Birkás
- Medical School, Institute of Behavioural Sciences, University of Pécs, Pécs, Hungary
| | - Árpád Csathó
- Medical School, Institute of Behavioural Sciences, University of Pécs, Pécs, Hungary
| | - István Hartung
- Medical School, Institute of Behavioural Sciences, University of Pécs, Pécs, Hungary
| | - Tamás Nagy
- Medical School, Department of Laboratory Medicine, University of Pécs, Pécs, Hungary
| | - László Czopf
- Medical School, First Department of Medicine, Division of Cardiology and Angiology, University of Pécs, Pécs, Hungary
| | - Ferenc Izbéki
- First Department of Internal Medicine, Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - László Gajdán
- First Department of Internal Medicine, Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Mária Papp
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Debrecen, Hungary
| | - László Czakó
- Faculty of Medicine, First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Dóra Illés
- Faculty of Medicine, First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Marco V Marino
- General and Emergency Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Antonello Mirabella
- General and Emergency Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Yaroslav Susak
- Department of Surgery, Bogomolets National Medical University, Kyiv, Ukraine
| | - Kristina Opalchuk
- Department of Surgery, Bogomolets National Medical University, Kyiv, Ukraine
| | - Gabriele Capurso
- Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Laura Apadula
- Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Cristian Gheorghe
- Clinical Institute Fundeni, Bucuresti, Romania
- Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Ionut Adrian Saizu
- Clinical Institute Fundeni, Bucuresti, Romania
- Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | | | - Enrique de-Madaria
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jonas Rosendahl
- Department of Internal Medicine I, Martin Luther University, Halle, Germany
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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7
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Romańczyk M, Ostrowski B, Kozłowska-Petriczko K, Pawlak KM, Kurek K, Zatorski H, Koziej M, Romańczyk T, Wosiewicz P, Marek T, Wiechowska-Kozłowska A, Małecka-Panas E, Hartleb M. Scoring system assessing mucosal visibility of upper gastrointestinal tract: The POLPREP scale. J Gastroenterol Hepatol 2022; 37:164-168. [PMID: 34397116 DOI: 10.1111/jgh.15662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/20/2021] [Accepted: 08/07/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM The proper visibility of mucosa during esophagogastroduodenoscopy (EGD) is crucial for the detection of early upper gastrointestinal tract lesions. In contrast to colonoscopy, no validated scoring system for the assessment of upper gastrointestinal mucosal cleanliness has been developed so far. The aim of the study was to create and validate standardized grading system (POLPREP) to assess the mucosal cleanliness during EGD. METHODS To assess the visibility of mucosa during EGD, 4-point scale was developed (0-3). Twelve operators assessed 18 images of esophagus, stomach, and duodenum twice (in 2 weeks interval). In validation round, the images and endoscopy reports of 443 EGDs performed in six centers were assessed. RESULTS The inter-observer accordance of POLPREP was 0.8 (intra-class correlation coefficient; 0.79 consultants, 0.85 trainees). The intra-observer repeatability was 0.64 (Fleiss kappa value; 0.64 consultants, 0.64 trainees). The lesions detection rate was significantly higher in clean (scores 2 and 3; 19.7%) than in "unclean" segments (score 1; 7.7%, P = 0.049). Score 3 was associated with over three-fold higher lesion detection than score 1 (odds ratio 3.2, 95% confidence interval 1.1-9; P = 0.03). CONCLUSIONS The proposed POLPREP scale allows for unified assessment of upper gastrointestinal tract mucosal cleanliness. The higher cleanliness scores are related with greater upper gastrointestinal pathologies detection.
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Affiliation(s)
- Marcin Romańczyk
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.,Endotherapy, H-T. Medical Center, Tychy, Poland
| | - Bartosz Ostrowski
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Katarzyna M Pawlak
- Department of Gastroenterology, Endoscopy Unit, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Krzysztof Kurek
- Department of Gastroenterology and Internal Medicine, Medical University of Białystok, Białystok, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Łódź, Łódź, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Piotr Wosiewicz
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Tomasz Marek
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Łódź, Łódź, Poland
| | - Marek Hartleb
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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8
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Dudek P, Fabisiak A, Zatorski H, Malecka-Wojciesko E, Talar-Wojnarowska R. Efficacy, Safety and Future Perspectives of JAK Inhibitors in the IBD Treatment. J Clin Med 2021; 10:jcm10235660. [PMID: 34884361 PMCID: PMC8658230 DOI: 10.3390/jcm10235660] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 12/16/2022] Open
Abstract
Although development of biologics has importantly improved the effectiveness in inducing and maintaining remission in inflammatory bowel disease (IBD), biologic therapies still have several limitations. Effective, low-cost drug therapy with good safety profile and compliance is therefore a substantial unmet medical need. A promising target for IBD treatment strategies are Janus kinase (JAK) inhibitors, which are small molecules that interact with cytokines implicated in pathogenesis of IBD. In contrast to monoclonal antibodies, which are able to block a single cytokine, JAK inhibitors have the potential to affect multiple cytokine-dependent immune pathways, which may improve the therapeutic response in some IBD patients. Tofacitinib, inhibiting signaling via different types of JAKs, has been already approved for ulcerative colitis, and several other small-molecule are still under investigation. However, one of the main concerns about using JAK inhibitors is the risk of thromboembolic events. Moreover, patients with COVID-19 appear to have an increased susceptibility for immunothrombosis. Therefore, thrombotic complications may become a serious limitation in the use of JAK inhibitors in the SARS-CoV-2 pandemic. As many questions about safety and efficacy of small molecules still remain unclear, in our review we present the current data regarding approved JAK inhibitors, as well as those in clinical development for the treatment of IBD.
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Affiliation(s)
- Patrycja Dudek
- Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland; (A.F.); (H.Z.); (E.M.-W.); (R.T.-W.)
- Correspondence: ; Tel.: +48-42677-66-67
| | - Adam Fabisiak
- Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland; (A.F.); (H.Z.); (E.M.-W.); (R.T.-W.)
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, 92-215 Lodz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland; (A.F.); (H.Z.); (E.M.-W.); (R.T.-W.)
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, 92-215 Lodz, Poland
| | - Ewa Malecka-Wojciesko
- Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland; (A.F.); (H.Z.); (E.M.-W.); (R.T.-W.)
| | - Renata Talar-Wojnarowska
- Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland; (A.F.); (H.Z.); (E.M.-W.); (R.T.-W.)
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9
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Zatorski H, Salaga M, Zielińska M, Mokrowiecka A, Jacenik D, Krajewska WM, Małecka-Panas E, Fichna J. Colonic inflammation induces changes in glucose levels through modulation of incretin system. Pharmacol Rep 2021; 73:1670-1679. [PMID: 34535873 PMCID: PMC8599322 DOI: 10.1007/s43440-021-00327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022]
Abstract
Background The role of the incretin hormone, glucagon-like peptide (GLP-1), in Crohn’s disease (CD), is still poorly understood. The aim of this study was to investigate whether colitis is associated with changes in blood glucose levels and the possible involvement of the incretin system as an underlaying factor. Methods We used a murine model of colitis induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS). Macroscopic and microscopic score and expression of inflammatory cytokines were measured. The effect of colitis on glucose level was studied by measurement of fasting glucose and GLP-1, dipeptidyl peptidase IV (DPP IV) levels, prohormone convertase 1/3 (PC 1/3) and GLP-1 receptor (GLP-1R) expression in mice. We also measured the level of GLP-1, DPP IV and expression of glucagon (GCG) and PC 1/3 mRNA in serum and colon samples from healthy controls and CD patients. Results Fasting glucose levels were increased in animals with colitis compared to controls. GLP-1 was decreased in both serum and colon of mice with colitis in comparison to the control group. DPP IV levels were significantly increased in serum, but not in the colon of mice with colitis as compared to healthy animals. Furthermore, PC 1/3 and GLP-1R expression levels were increased in mice with colitis as compared to controls. In humans, no differences were observed in fasting glucose level between healthy subjects and CD patients. GLP-1 levels were significantly decreased in the serum. Interestingly, GLP-1 level was significantly increased in colon samples of CD patients compared to healthy subjects. No significant differences in DPP IV levels in serum and colon samples were observed between groups. Conclusions Changes in the incretin system during colitis seem to contribute to the impaired glucose levels. Differences in incretin levels seem to be modulated by degrading enzyme DPP-IV and PC 1/3. Obtained results suggest that the incretin system may become a novel therapeutic approach in the treatment of CD.
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Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland.,Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Maciej Salaga
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland
| | - Marta Zielińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Damian Jacenik
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Wanda Małgorzata Krajewska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland.
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10
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Cichoż-Lach H, Michalak A, Kopertowska-Majchrzak M, Eder P, Stawczyk-Eder K, Waszak K, Talar-Wojnarowska R, Zatorski H, Solarska-Półchłopek A, Chmielnicki J, Filip R, Pękala A, Janiak M, Skrobot K, Kasińska E, Krogulecki M, Królikowski P, Kłopocka M, Liebert A, Poniewierka E, Smoła I, Gąsiorowska A, Kaczka A, Wypych J, Wojciechowski K, Drygała S, Zagórowicz E. Characteristics of patients with moderate-to-severe ulcerative colitis treated with vedolizumab: results from a Polish multicenter, prospective, observational real-life study (the POLONEZ study). Therap Adv Gastroenterol 2021; 14:17562848211036456. [PMID: 34484422 PMCID: PMC8411627 DOI: 10.1177/17562848211036456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/12/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Vedolizumab, a humanized antibody targeting the α4β7 integrin, was proven to be effective in the treatment of moderate-to-severe ulcerative colitis (UC) in randomized clinical trials. The aim of the POLONEZ study is to determine the demographic and clinical characteristics of the patients with UC treated with vedolizumab within the scope of the National Drug Program in Poland and to assess the real-world effectiveness and safety of vedolizumab in the study population. Here we report the demographic and clinical characteristics of these patients. METHODS This prospective study included adult patients eligible for UC treatment with vedolizumab who were recruited from 12 centers in Poland between February and November 2019. Collected data included sex, age, disease duration, presence of extraintestinal manifestations or comorbidities, status of previous biologic treatment, and current concomitant treatment. Disease extent was determined according to the Montreal classification, and disease activity was measured with the Mayo Score. RESULTS A total of 100 (55 biologic-naïve and 45 biologic-exposed) patients were enrolled in the study (51% female, median age 35 years). Among biologic-exposed patients (mostly infliximab-treated), 57% had failed to respond to the therapy. The disease duration was significantly shorter in biologic-naïve (median 5 years) than in biologic-exposed (8 years, p = 0.004) or biofailure patients (7 years, p = 0.04). In the overall population the median Total Mayo Score was 10. Disease extent and activity were similar between the subgroups. CONCLUSIONS Our study indicates that patients treated with vedolizumab in Poland receive the drug relatively early after UC diagnosis, but their disease is advanced. More than half of the patients had not been treated with biologic drugs before initiating vedolizumab. The study was registered in ENCePP database (EUPAS34119). LAY SUMMARY Characteristics of patients treated for ulcerative colitis with vedolizumab in Poland Treatment of moderate-to-severe ulcerative colitis (UC) with the integrin antagonist vedolizumab became available within the Polish National Drug Program (NDP) in 2018. In this study, for the first time, we provide detailed demographic and clinical characteristics of 100 patients (median age 35 years, 51% female) treated with vedolizumab in Poland, of whom 55 were biologic-naïve and 45 biologic-exposed. The median duration of disease was 6 years. The disease duration was shorter in biologic-naïve than in biologic-exposed patients. Most patients were affected by extensive colitis (52%) or left-sided colitis (42%). Median disease activity was 10 according to the Total Mayo Score. Sixty-eight patients received concomitant systemic corticosteroids and 45 patients received immunomodulators. Our findings indicate that Polish patients receiving vedolizumab have a high disease activity and are treated relatively early after UC diagnosis. This might be due to the criteria for inclusion of a patient in the NDP.
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Affiliation(s)
- Halina Cichoż-Lach
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | - Agata Michalak
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | | | - Piotr Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | | | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical
University of Lodz, Łódź, Poland
| | - Anna Solarska-Półchłopek
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| | | | - Rafał Filip
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Anna Pękala
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology,
Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology,
Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Kasińska
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Michał Krogulecki
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Piotr Królikowski
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Elżbieta Poniewierka
- Department of Gastroenterology and Hepatology,
Wrocław Medical University, Wrocław, Poland
| | - Izabela Smoła
- Department of Gastroenterology and Hepatology,
Wrocław Medical University, Wrocław, Poland
| | - Anita Gąsiorowska
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy—Central Veterans’
Hospital, Łódź, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy—Central Veterans’
Hospital, Łódź, Poland
| | - Joanna Wypych
- Department of Gastroenterology, Surgery and
Nutrition, Copernicus Hospital, Gdańsk, Poland
| | | | | | - Edyta Zagórowicz
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
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Zatorski H, Salaga M, Zielińska M, Majchrzak K, Binienda A, Kordek R, Małecka-Panas E, Fichna J. AdipoRon, an Orally Active, Synthetic Agonist of AdipoR1 and AdipoR2 Receptors Has Gastroprotective Effect in Experimentally Induced Gastric Ulcers in Mice. Molecules 2021; 26:molecules26102946. [PMID: 34063466 PMCID: PMC8156685 DOI: 10.3390/molecules26102946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction: Adiponectin is a hormone secreted by adipocytes, which exhibits insulin-sensitizing and anti-inflammatory properties and acts through adiponectin receptors: AdipoR1 and AdipoR2. The aim of the study was to evaluate whether activation of adiponectin receptors AdipoR1 and AdipoR2 with an orally active agonist AdipoRon has gastroprotective effect and to investigate the possible underlying mechanism. Methods: We used two well-established mouse models of gastric ulcer (GU) induced by oral administration of EtOH (80% solution in water) or diclofenac (30 mg/kg, p.o.). Gastroprotective effect of AdipoRon (dose 5 and 50 mg/kg p.o.) was compared to omeprazole (20 mg/kg p.o.) or 5% DMSO solution (control). Clinical parameters of gastroprotection were assessed using macroscopic (gastric lesion area) and microscopic (evaluation of the gastric mucosa damage) scoring. To establish the molecular mechanism, we measured: myeloperoxidase (MPO), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) activities; glutathione (GSH) level; and IL-1β, adenosine monophosphate-activated protein kinase (AMPK), and phosphorylated AMPK expression in gastric tissue. Results: AdipoRon produced a gastroprotective effect in both GU mouse models as evidenced by significantly lower macroscopic and microscopic damage scores. AdipoRon exhibited anti-inflammatory effect by reduction in MPO activity and IL-1β expression in the gastric tissue. Moreover, AdipoRon induced antioxidative action, as demonstrated with higher GSH levels, and increased SOD and GPX activity. Conclusions: Activation of AdipoR1 and AdipoR2 using AdipoRon reduced gastric lesions and enhanced cell response to oxidative stress. Our data suggest that AdipoR1 and AdipoR2 activation may be an attractive therapeutic strategy to inhibit development of gastric ulcers.
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Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
- Department of Digestive Tract Diseases, Medical University of Lodz, 93-281 Lodz, Poland;
| | - Maciej Salaga
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
| | - Marta Zielińska
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
| | - Kinga Majchrzak
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
| | - Agata Binienda
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
| | - Radzisław Kordek
- Department of Pathology, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, 93-281 Lodz, Poland;
| | - Jakub Fichna
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (H.Z.); (M.S.); (M.Z.); (K.M.); (A.B.)
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
- Correspondence: ; Tel.: +48-42-272-57-07
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12
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Demcsák A, Soós A, Kincses L, Capunge I, Minkov G, Kovacheva-Slavova M, Nakov R, Wu D, Huang W, Xia Q, Deng L, Hollenbach M, Schneider A, Hirth M, Ioannidis O, Vincze Á, Bajor J, Sarlós P, Czakó L, Illés D, Izbéki F, Gajdán L, Papp M, Hamvas J, Varga M, Kanizsai P, Bóna E, Mikó A, Váncsa S, Juhász MF, Ocskay K, Darvasi E, Miklós E, Erőss B, Szentesi A, Párniczky A, Casadei R, Ricci C, Ingaldi C, Mastrangelo L, Jovine E, Cennamo V, Marino MV, Barauskas G, Ignatavicius P, Pelaez-Luna M, Rios AS, Turcan S, Tcaciuc E, Małecka-Panas E, Zatorski H, Nunes V, Gomes A, Gonçalves TC, Freitas M, Constantino J, Sá M, Pereira J, Mateescu B, Constantinescu G, Sandru V, Negoi I, Ciubotaru C, Negoita V, Bunduc S, Gheorghe C, Barbu S, Tantau A, Tantau M, Dumitru E, Suceveanu AI, Tocia C, Gherbon A, Litvin A, Shirinskaya N, Rabotyagova Y, Bezmarevic M, Hegyi PJ, Han J, Rodriguez-Oballe JA, Salas IM, Comas EP, Garcia DDLI, Cuadrado AJ, Castiñeira AQ, Chang YT, Chang MC, Kchaou A, Tlili A, Kacar S, Gökbulut V, Duman D, Kani HT, Altintas E, Chooklin S, Chuklin S, Gougol A, Papachristou G, Hegyi P. Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study. Pancreatology 2020; 20:1323-1331. [PMID: 32948430 DOI: 10.1016/j.pan.2020.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP. METHODS We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. RESULTS Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality. CONCLUSIONS Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP.
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Affiliation(s)
- Alexandra Demcsák
- Department of Pediatrics and Pediatric Health Centre, University of Szeged, Szeged, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Lilla Kincses
- Department of Pediatrics and Pediatric Health Centre, University of Szeged, Szeged, Hungary
| | | | - Georgi Minkov
- Department of Surgery, University Hospital, Stara Zagora, Bulgaria
| | - Mila Kovacheva-Slavova
- Department of Gastroenterology, Queen Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Radislav Nakov
- Department of Gastroenterology, Queen Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Dong Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Wei Huang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Lihui Deng
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Marcus Hollenbach
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Alexander Schneider
- Department of Gastroenterology and Hepatology, Klinikum Bad Hersfeld, Bad Hersfeld, Germany; Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Hirth
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Orestis Ioannidis
- Fourth Surgical Department, Medical School, Aristotle, University of Thessaloniki, Thessaloniki, Greece
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Patrícia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - László Czakó
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Dóra Illés
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Ferenc Izbéki
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - László Gajdán
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Mária Papp
- Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Márta Varga
- Department of Gastroenterology, BMKK Dr. Réthy Pál Hospital, Békéscsaba, Hungary
| | - Péter Kanizsai
- Department of Emergency Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Ernő Bóna
- Department of Emergency Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márk Félix Juhász
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Klementina Ocskay
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Erika Darvasi
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Emőke Miklós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Riccardo Casadei
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Claudio Ricci
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Carlo Ingaldi
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Laura Mastrangelo
- Unit of General Surgery, Ausl Bologna Bellaria, Maggiore Hospital, Bologna, Italy
| | - Elio Jovine
- Department of Surgery, Ausl Bologna Bellaria, Maggiore Hospital, Bologna, Italy
| | - Vincenzo Cennamo
- Unit of Gastroenterology and Digestive Endoscopy, Ausl Bologna Bellaria, Maggiore Hospital, Bologna, Italy
| | - Marco V Marino
- Emergency and General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy; General Surgery Department, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Giedrius Barauskas
- Division of HPB Surgery, Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Ignatavicius
- Division of HPB Surgery, Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mario Pelaez-Luna
- Department of Gastroenterology, Pancreatic Disorders Unit, National Institute of Medical Sciences and Nutrition Salvador Zubiran, UNAM. Mexico City, Mexico
| | - Andrea Soriano Rios
- Department of Gastroenterology, Pancreatic Disorders Unit, National Institute of Medical Sciences and Nutrition Salvador Zubiran, UNAM. Mexico City, Mexico
| | - Svetlana Turcan
- Department of Gastroenterology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Eugen Tcaciuc
- Department of Gastroenterology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Vitor Nunes
- HPB Surgery, Department of Surgery, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal
| | - Antonio Gomes
- HPB Surgery, Department of Surgery, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal
| | - Tiago Cúrdia Gonçalves
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; School of Medicine, University of Minho, Braga/Guimarães, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Marta Freitas
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; School of Medicine, University of Minho, Braga/Guimarães, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Júlio Constantino
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Milene Sá
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Jorge Pereira
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Bogdan Mateescu
- Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriel Constantinescu
- Gastroenterology Department, Bucharest Emergency Hospital, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Vasile Sandru
- Gastroenterology Department, Bucharest Emergency Hospital, Bucharest, Romania
| | - Ionut Negoi
- Surgery Department, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cezar Ciubotaru
- Surgery Department, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Valentina Negoita
- Surgery Department, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Stefania Bunduc
- Fundeni Clinical Institute, Gastroenterology, Hepatology and Liver Transplant Department, Bucharest, Romania
| | - Cristian Gheorghe
- Fundeni Clinical Institute, Gastroenterology, Hepatology and Liver Transplant Department, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Barbu
- 4th Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Alina Tantau
- The 4th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Marcel Tantau
- Department of Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Prof. Octavian Fodor Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Eugen Dumitru
- Faculty of Medicine, Ovidius University of Constanta, County, Emergency, and Clinical Hospital of Constanta, Constanta, Romania
| | - Andra Iulia Suceveanu
- Faculty of Medicine, Ovidius University of Constanta, County, Emergency, and Clinical Hospital of Constanta, Constanta, Romania
| | - Cristina Tocia
- Faculty of Medicine, Ovidius University of Constanta, County, Emergency, and Clinical Hospital of Constanta, Constanta, Romania
| | - Adriana Gherbon
- Diabetes, Nutrition, Metabolic Diseases and Internal Medicine Clinic, University of Medicine and Pharmacy V. Babes Timisoara, County Hospital Pius Branzeu, Timisoara, Romania
| | - Andrey Litvin
- Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | - Natalia Shirinskaya
- Omsk State Medical Information-Analytical Centre, Omsk State Medical University, Omsk State Clinical Emergency Hospital #2, Omsk, Russia
| | - Yliya Rabotyagova
- Medical Academy Named after S.I. Georgievsky, Crimean Federal University Named after V.I. Vernadsky, Simferopol, Russia
| | - Mihailo Bezmarevic
- Department of Hepatobiliary and Pancreatic Surgery, Clinic for General Surgery, Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Péter Jenő Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Department of Gastroenterology, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Jimin Han
- Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University Medical Center and School of Medicine, Daegu, South Korea
| | - Juan Armando Rodriguez-Oballe
- Department of Gastroenterology, University Hospital Santa María - University Hospital Arnau de Vilanova, Lerida, Spain
| | - Isabel Miguel Salas
- Department of Gastroenterology, University Hospital Santa María - University Hospital Arnau de Vilanova, Lerida, Spain
| | - Eva Pijoan Comas
- Department of Gastroenterology, University Hospital Santa María - University Hospital Arnau de Vilanova, Lerida, Spain
| | - Daniel de la Iglesia Garcia
- Department of Gastroenterology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Andrea Jardi Cuadrado
- Department of Gastroenterology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adriano Quiroga Castiñeira
- Department of Gastroenterology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Yu-Ting Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chu Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ali Kchaou
- Department of Digestive Surgery, Habib Bourguiba Teaching Hospital, Sfax, Tunisia
| | - Ahmed Tlili
- Department of Digestive Surgery, Habib Bourguiba Teaching Hospital, Sfax, Tunisia
| | - Sabite Kacar
- Department of Gastroenterology, Yüksek Ihtisas Hastanesi, Ankara, Turkey
| | - Volkan Gökbulut
- Department of Gastroenterology, Yüksek Ihtisas Hastanesi, Ankara, Turkey
| | - Deniz Duman
- Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Haluk Tarik Kani
- Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Engin Altintas
- Gastroenterology Department, Faculty of Medicine, Ovidius University, Constanta, Romania
| | - Serge Chooklin
- Department of Surgery, Regional Clinical Hospital, Lviv, Ukraine
| | - Serhii Chuklin
- Department of Surgery, Regional Clinical Hospital, Lviv, Ukraine
| | - Amir Gougol
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - George Papachristou
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary.
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Zielińska M, Szymaszkiewicz A, Jacenik D, Schodel L, Sałaga M, Zatorski H, Kordek R, Becker C, Krajewska WM, Fichna J. Cyclic derivative of morphiceptin Dmt-cyclo-(D-Lys-Phe-D-Pro-Asp)-NH2(P-317), a mixed agonist of MOP and KOP opioid receptors, exerts anti-inflammatory and anti-tumor activity in colitis and colitis-associated colorectal cancer in mice. Eur J Pharmacol 2020; 885:173463. [PMID: 32835668 DOI: 10.1016/j.ejphar.2020.173463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 12/07/2022]
Abstract
Endogenous opioid system is involved in the maintenance of the intestinal homeostasis. Recently, we proved that stimulation of opioid receptors using P-317, a cyclic morphiceptin analog, resulted in the alleviation of acute colitis in mice. The aim of the current study was to assess the effect of P-317 during colitis and colitis-associated colorectal cancer in mice. Colitis was induced by addition of dextran sodium sulfate (DSS) into drinking water. Colitis-associated colorectal cancer was induced by a single intraperitoneal injection of azoxymethane (AOM) and subsequent addition of DSS into drinking water (week 2, 5, 8). During macroscopic damage evaluation the samples were collected and used for biochemical (MPO activity assay), molecular (qPCR and western blot) and histological studies. In experimental colitis, P-317 induced an anti-inflammatory response as indicated by macroscopic and microscopic scores. In the colitis-associated colorectal cancer model, a significant difference in colorectal tumor development was observed between vehicle- and P-317-treated mice. P-317 decreased the total number of colonic tumors and inhibited MPO activity. Hematoxylin and eosin staining confirmed anti-tumor activity of P-317. The expression of TNF-α was decreased in P-317-treated mice as compared to the vehicle-treated group. P-317 decreased proliferation as well as β-catenin expression in tumors. P-317, a mixed MOP and KOP receptor agonist, induced an anti-inflammatory response in experimental colitis and decreased tumor development in colitis-associated colorectal cancer in mice.
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Affiliation(s)
- Marta Zielińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Agata Szymaszkiewicz
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Damian Jacenik
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Lena Schodel
- Department of Medicine 1, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Maciej Sałaga
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Hubert Zatorski
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland; Department of Digestive Diseases, Medical Univeristy of Lodz, Lodz, Poland
| | - Radzisław Kordek
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Christoph Becker
- Department of Medicine 1, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Wanda M Krajewska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
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Zatorski H, Nakov R. Faecal Microbiota Transplantation in Inflammatory Bowel Disease: Current Concepts and Future Challenges. Curr Drug Targets 2020; 21:1440-1447. [PMID: 32484770 DOI: 10.2174/1389450121666200602125507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/26/2022]
Abstract
Dysbiosis has been repeatedly observed in inflammatory bowel disease (IBD) and is now recognized as an essential factor in the gut inflammatory process. IBD is a significant burden to health-care systems, mainly due to treatment-related costs. Available treatments have several limitations: up to 30% of patients are primary non-responders, and between 10 and 20% lose response per year, requiring a dose-escalation or a switch to another biologic. Hence, the current IBD treatment is not sufficient, and there is an urgent need to introduce new therapies in the management of these patients. Recently, the correction of dysbiosis has become an attractive approach from a therapeutic point of view. Faecal microbiota transplantation (FMT) appears as a reliable and potentially beneficial therapy in IBD patients. There is developing data that FMT for mild-to-moderately active UC is a safe and efficient therapy for the induction of remission. However, the current studies have different designs and have a short follow up, which makes clinical interpretation significantly difficult. There is a need for RCTs with a well-defined study cohort using FMT for the therapy of CD patients. The location, behavior, and severity of the disease should be taken into account. The goal of this manuscript is to review the data currently available on FMT and IBD, to explain FMT principles and methodology in IBD patients and to discuss some unresolved issues.
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Affiliation(s)
- Hubert Zatorski
- Department of Digestive Tract Diseasesx,Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Radislav Nakov
- Clinic of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria
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15
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Párniczky A, Lantos T, Tóth EM, Szakács Z, Gódi S, Hágendorn R, Illés D, Koncz B, Márta K, Mikó A, Mosztbacher D, Németh BC, Pécsi D, Szabó A, Szücs Á, Varjú P, Szentesi A, Darvasi E, Erőss B, Izbéki F, Gajdán L, Halász A, Vincze Á, Szabó I, Pár G, Bajor J, Sarlós P, Czimmer J, Hamvas J, Takács T, Szepes Z, Czakó L, Varga M, Novák J, Bod B, Szepes A, Sümegi J, Papp M, Góg C, Török I, Huang W, Xia Q, Xue P, Li W, Chen W, Shirinskaya NV, Poluektov VL, Shirinskaya AV, Hegyi PJ, Bátovský M, Rodriguez-Oballe JA, Salas IM, Lopez-Diaz J, Dominguez-Munoz JE, Molero X, Pando E, Ruiz-Rebollo ML, Burgueño-Gómez B, Chang YT, Chang MC, Sud A, Moore D, Sutton R, Gougol A, Papachristou GI, Susak YM, Tiuliukin IO, Gomes AP, Oliveira MJ, Aparício DJ, Tantau M, Kurti F, Kovacheva-Slavova M, Stecher SS, Mayerle J, Poropat G, Das K, Marino MV, Capurso G, Małecka-Panas E, Zatorski H, Gasiorowska A, Fabisiak N, Ceranowicz P, Kuśnierz-Cabala B, Carvalho JR, Fernandes SR, Chang JH, Choi EK, Han J, Bertilsson S, Jumaa H, Sandblom G, Kacar S, Baltatzis M, Varabei AV, Yeshy V, Chooklin S, Kozachenko A, Veligotsky N, Hegyi P. Antibiotic therapy in acute pancreatitis: From global overuse to evidence based recommendations. Pancreatology 2019; 19:488-499. [PMID: 31068256 DOI: 10.1016/j.pan.2019.04.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Unwarranted administration of antibiotics in acute pancreatitis presents a global challenge. The clinical reasoning behind the misuse is poorly understood. Our aim was to investigate current clinical practices and develop recommendations that guide clinicians in prescribing antibiotic treatment in acute pancreatitis. METHODS Four methods were used. 1) Systematic data collection was performed to summarize current evidence; 2) a retrospective questionnaire was developed to understand the current global clinical practice; 3) five years of prospectively collected data were analysed to identify the clinical parameters used by medical teams in the decision making process, and finally; 4) the UpToDate Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was applied to provide evidence based recommendations for healthcare professionals. RESULTS The systematic literature search revealed no consensus on the start of AB therapy in patients with no bacterial culture test. Retrospective data collection on 9728 patients from 22 countries indicated a wide range (31-82%) of antibiotic use frequency in AP. Analysis of 56 variables from 962 patients showed that clinicians initiate antibiotic therapy based on increased WBC and/or elevated CRP, lipase and amylase levels. The above mentioned four laboratory parameters showed no association with infection in the early phase of acute pancreatitis. Instead, procalcitonin levels proved to be a better biomarker of early infection. Patients with suspected infection because of fever had no benefit from antibiotic therapy. CONCLUSIONS The authors formulated four consensus statements to urge reduction of unjustified antibiotic treatment in acute pancreatitis and to use procalcitonin rather than WBC or CRP as biomarkers to guide decision-making.
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Affiliation(s)
- Andrea Párniczky
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; Heim Pál National Insititute of Pediatrics, Budapest, Hungary
| | - Tamás Lantos
- Department of Medical Physics and Informatics, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Eszter Margit Tóth
- Pándy Kálmán Hospital of Békés County, Gyula, Hungary; First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Gódi
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Roland Hágendorn
- Intesive Care Unit, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Dóra Illés
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Balázs Koncz
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Katalin Márta
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; Division of Translational Medicine, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Dóra Mosztbacher
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Balázs Csaba Németh
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary; Hungarian Academy of Sciences-University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary
| | - Dániel Pécsi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Anikó Szabó
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Szücs
- First Department of Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Varjú
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Erika Darvasi
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Ferenc Izbéki
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - László Gajdán
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Adrienn Halász
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Imre Szabó
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriella Pár
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Patrícia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Czimmer
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | | | - Tamás Takács
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zoltán Szepes
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - László Czakó
- First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | - János Novák
- Pándy Kálmán Hospital of Békés County, Gyula, Hungary
| | | | | | - János Sümegi
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Mária Papp
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Debrecen, Hungary
| | - Csaba Góg
- Healthcare Center of County Csongrád, Makó, Hungary
| | - Imola Török
- County Emergency Clinical Hospital of Targu Mures Hospital, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Wei Huang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital of Sichuan University, Chengdu, China
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital of Sichuan University, Chengdu, China
| | - Ping Xue
- Department of Integrated Traditional Chinese and Western Medicine, Shangjin Hospital, West China Medical School of Sichuan University, Chengdu, China
| | - Weiqin Li
- Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weiwei Chen
- Department of Gastroenterology, Subei People's Hospital of Jiangsu Province, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Natalia V Shirinskaya
- Omsk State Medical Information-Analytical Centre, Omsk State Clinical Emergency Hospital #2, Omsk, Russia
| | | | - Anna V Shirinskaya
- Department of Surgery and Urology, Omsk State Medical University, Omsk, Russia
| | - Péter Jenő Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; Departement of Gastroenterology Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Marian Bátovský
- Departement of Gastroenterology Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Juan Armando Rodriguez-Oballe
- Department of Gastroenterology, University Hospital Santa María - University Hospital Arnau de Vilanova, Lerida, Spain
| | - Isabel Miguel Salas
- Department of Gastroenterology, University Hospital Santa María - University Hospital Arnau de Vilanova, Lerida, Spain
| | - Javier Lopez-Diaz
- Department of Gastroenterology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Enrique Dominguez-Munoz
- Department of Gastroenterology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Xavier Molero
- Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron - Institut de Recerca, Autonomous University of Barcelona, CIBEREHD, Barcelona, Spain
| | - Elizabeth Pando
- Department of Hepato-pancreato-biliary and Transplat Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Beatriz Burgueño-Gómez
- Digestive Diseases Department Clinical University Hospital of Valladolid, Valladolid, Spain
| | - Yu-Ting Chang
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Chu Chang
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ajay Sud
- Liverpool Pancreatitis Research Group, University of Liverpool and the Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, United Kingdom
| | - Danielle Moore
- Liverpool Pancreatitis Research Group, University of Liverpool and the Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, United Kingdom
| | - Robert Sutton
- Liverpool Pancreatitis Research Group, University of Liverpool and the Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, United Kingdom
| | - Amir Gougol
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Georgios I Papachristou
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - António Pedro Gomes
- Department of Surgery, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal
| | | | - David João Aparício
- Department of Surgery, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal
| | - Marcel Tantau
- Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Internal Medicine, 3rd Medical Clinic and "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Floreta Kurti
- Department of Gastroenterology and Hepatology, University Hospital Center "Mother Theresa", Tirana, Albania
| | - Mila Kovacheva-Slavova
- University Hospital "Tsaritsa Ioanna - ISUL", Departement of Gastroenterology, Sofia, Bulgaria
| | | | - Julia Mayerle
- Department of Medicine II, University Hospital, LMU Munich, Germany
| | - Goran Poropat
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Croatia
| | - Kshaunish Das
- Division of Gastroenterology, School of Digestive and Liver Diseases, IPGME &R, Kolkata, India
| | - Marco Vito Marino
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Gabriele Capurso
- PancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Poland
| | | | - Natalia Fabisiak
- Department of Gastroenterology Medical University of Lodz, Poland
| | - Piotr Ceranowicz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Beata Kuśnierz-Cabala
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Joana Rita Carvalho
- Department of Gastroenterology and Hepatology, North Lisbon Hospital Center, Hospital Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Samuel Raimundo Fernandes
- Department of Gastroenterology and Hepatology, North Lisbon Hospital Center, Hospital Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Jae Hyuck Chang
- Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Kwang Choi
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, South Korea
| | - Jimin Han
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Sara Bertilsson
- Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Health Sciences, Lund University, Lund, Sweden
| | - Hanaz Jumaa
- Eskilstuna Hospital, Mälarsjukhuset, Eskilstuna, Sweden
| | - Gabriel Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Sabite Kacar
- Department of Gastroenterology Türkiye Yüksek İhtisas Hospital, Ankara, Turkey
| | - Minas Baltatzis
- Manchester Royal Infirmary Hospital, Manchester, United Kingdom
| | | | - Vizhynis Yeshy
- Department of Surgery, Belarusian Medical Academy Postgraduate Education, Minsk, Belarus
| | | | - Andriy Kozachenko
- Kharkiv Emergency Hospital, Medical Faculty of V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - Nikolay Veligotsky
- Department Thoraco-abdominal Surgery Kharkov Medical Academy Postgraduate Education, Kharkov, Ukraine
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary; Division of Translational Medicine, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary; Hungarian Academy of Sciences-University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary.
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16
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Zielinska M, Szymaszkiewicz A, Salaga M, Zatorski H, Wlodarczyk J, Jacenik D, Kordek R, Krajewska WM, Misicka A, Fichna J, Sacharczuk M. High activity of the endogenous opioid system and acute but not chronic stress influence experimental colitis development in mice. J Physiol Pharmacol 2019; 69. [PMID: 30683828 DOI: 10.26402/jpp.2018.5.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/30/2018] [Indexed: 11/03/2022]
Abstract
Exposition to environmental factors is one of the major underlying causes in inflammatory bowel diseases (IBD), with several endogenous systems involved. Our aim was to characterize the impact of stress on the colitis development in relation to the endogenous opioid system (EOS) activity in mice. A unique mouse model of high and low activity of EOS (namely high (HA)/low (LA) stress-induced analgesia) was employed. Mice were bred using bidirectional selection and classified as HA or LA line based on the measurement of analgesia. Colitis was induced by instillation of trinitrobenzenesulfonic acid in 30% EtOH/0.9% NaCl. After 4 days, the macroscopic score was assessed and samples for molecular and histological studies were collected. To evaluate the influence of stress on colitis development, chronic mild stress (exposure to stress stimuli for 2 and 5 weeks) and acute stress (short restraint over 3 days) were applied before colitis induction. We observed a difference in the colitis development between non-stressed HA and LA mice, as indicated by macroscopic and ulcer scores. Acute stress improved colitis in HA mice but did not change the inflammation score in LA line as compared to respective non-stressed mice. Chronic mild stress had no influence on colitis in either of mouse lines. Our study supports the hypothesis that the activity of EOS may be crucial in IBD development. We also evidence that acute, but not chronic stress influenced IBD exacerbation, depending on EOS function.
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Affiliation(s)
- M Zielinska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - A Szymaszkiewicz
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - M Salaga
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - H Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - J Wlodarczyk
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - D Jacenik
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - R Kordek
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - W M Krajewska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - A Misicka
- Department of Neuropeptides, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - J Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
| | - M Sacharczuk
- Laboratory of Neurogenomics, Institute of Genetics and Animal Breeding, Polish Academy of Sciences, Jastrzebiec/Magdalenka, Poland.,Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland.,Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
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Drzazga A, Kristinsson H, Sałaga M, Zatorski H, Koziołkiewicz M, Gendaszewska-Darmach E, Bergsten P. Lysophosphatidylcholine and its phosphorothioate analogues potentiate insulin secretion via GPR40 (FFAR1), GPR55 and GPR119 receptors in a different manner. Mol Cell Endocrinol 2018; 472:117-125. [PMID: 29225068 DOI: 10.1016/j.mce.2017.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 11/08/2017] [Accepted: 12/07/2017] [Indexed: 12/29/2022]
Abstract
Lysophosphatidylcholine (LPC) is an endogenous ligand for GPR119 receptor, mediating glucose-stimulated insulin secretion (GSIS). We demonstrate that LPC facilitates GSIS in MIN6 pancreatic β-cell line and murine islets of Langerhans by recognizing not only GPR119 but also GPR40 (free fatty acid receptor 1) and GPR55 activated by lysophosphatidylinositol. Natural LPCs are unstable when administered in vivo limiting their therapeutic value and therefore, we present phosphorothioate LPC analogues with increased stability. All the modified LPCs under study (12:0, 14:0, 16:0, 18:0, and 18:1) significantly enhanced GSIS. The 16:0 sulfur analogue was the most potent, evoking 2-fold accentuated GSIS compared to the native counterpart. Interestingly, LPC analogues evoked GPR40-, GPR55-and GPR119-dependent [Ca2+]i signaling, but did not stimulate cAMP accumulation as in the case of unmodified molecules. Thus, introduction of a phosphorothioate function not only increases LPC stability but also modulates affinity towards receptor targets and evokes different signaling pathways.
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Affiliation(s)
- Anna Drzazga
- Institute of Technical Biochemistry, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, B. Stefanowskiego 4/10, 90-924 Lodz, Poland
| | - Hjalti Kristinsson
- Department of Medical Cell Biology, Uppsala University, Husargatan 3, 75123 Uppsala, Sweden
| | - Maciej Sałaga
- Department of Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Maria Koziołkiewicz
- Institute of Technical Biochemistry, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, B. Stefanowskiego 4/10, 90-924 Lodz, Poland
| | - Edyta Gendaszewska-Darmach
- Institute of Technical Biochemistry, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, B. Stefanowskiego 4/10, 90-924 Lodz, Poland.
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Husargatan 3, 75123 Uppsala, Sweden
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18
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Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Poland
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Zatorski H, Mosinska P, Storr M, Fichna J. Relamorelin and other ghrelin receptor agonists - future options for gastroparesis, functional dyspepsia and proton pump inhibitors-resistant non-erosive reflux disease. J Physiol Pharmacol 2017; 68:797-805. [PMID: 29550791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/28/2017] [Indexed: 06/08/2023]
Abstract
There is an unmet need for effective pharmacological therapies for the treatment of gastroparesis and other upper gastrointestinal (GI) motility disorders, which reduce patients' quality of life and are a burden to the healthcare system. Ghrelin is an endogenous growth hormone secretagogue receptor ligand and has been shown to exert prokinetic effects on GI motility. Nevertheless, considering the short half-life of ghrelin its use in clinical practice is limited. Thus, ghrelin receptor agonists with enhanced pharmacokinetics were developed; they accelerate gastric emptying and improve symptoms of gastroparesis in animal models and humans. This review summarizes the current knowledge on relamorelin, a potent ghrelin mimetic, and other analogs which are in preclinical or clinical development stages for the management of upper GI disorders.
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Affiliation(s)
- H Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
| | - P Mosinska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - M Storr
- Center of Endoscopy, Starnberg, Germany
| | - J Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
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20
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Siczek K, Fichna J, Zatorski H, Karolewicz B, Klimek L, Owczarek A. Development of the rectal dosage form with silver-coated glass beads for local-action applications in lower sections of the gastrointestinal tract. Pharm Dev Technol 2017; 23:295-300. [PMID: 28756715 DOI: 10.1080/10837450.2017.1359843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONTEXT Recent findings indicating the anti-inflammatory action of silver preparations through modulation of the gut microbiota and apoptosis of inflammatory cells predestine silver use in inflammatory bowel disease (IBD). OBJECTIVE The aim of our study was to validate the possibility of effective silver release from silver-coated glass beads for anti-inflammatory local application in the lower sections of the gastrointestinal (GI) tract. MATERIALS AND METHODS Silver-coated glass beads were prepared using magnetron method. Release of silver from the silver-coated glass bead surface was carried out in BIO-DIS reciprocating cylinder apparatus. Erosion of silver coating and indirect estimation of the silver release dynamics was assessed using scanning electron microscope. Rectal suppositories containing silver-coated glass beads were prepared using five different methods (M1-M5) and X-ray scanned for their composition. RESULTS AND DISCUSSION The XR microanalysis and the chemical composition analysis evidenced for a rapid (within 30 min) release of nearly 50% of silver from the coating of the glass beads, which remained stable up to 24 h of incubation. The most homogeneous distribution of beads in the entire volume of the suppository was obtained for formulation M5, where the molten base was poured into mold placed in an ice bath, and the beads were added after 10 s. CONCLUSIONS Our study is the first to present the concept of enclosing silver-coated glass beads in the lipophilic suppository base to attenuate inflammation in the lower GI tract and promises efficient treatment with reduced side effects.
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Affiliation(s)
- Krzysztof Siczek
- a Department of Biochemistry , Medical University of Lodz , Lodz , Poland.,b Department of Vehicles and Fundamentals of Machine Design , Lodz University of Technology , Lodz , Poland
| | - Jakub Fichna
- a Department of Biochemistry , Medical University of Lodz , Lodz , Poland
| | - Hubert Zatorski
- a Department of Biochemistry , Medical University of Lodz , Lodz , Poland
| | - Bożena Karolewicz
- c Department of Drug Form Technology, Faculty of Pharmacy , Wroclaw Medical University , Wroclaw , Poland
| | - Leszek Klimek
- d Department of Dental Technology, Chair of Restorative Dentistry, Faculty of Medicine , Medical University of Lodz , Lodz , Poland.,e Faculty of Mechanical Engineering, Institute of Materials Science and Engineering , Lodz University of Technology , Lodz , Poland
| | - Artur Owczarek
- c Department of Drug Form Technology, Faculty of Pharmacy , Wroclaw Medical University , Wroclaw , Poland
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Mosińska P, Zatorski H, Storr M, Fichna J. Future Treatment of Constipation-associated Disorders: Role of Relamorelin and Other Ghrelin Receptor Agonists. J Neurogastroenterol Motil 2017; 23:171-179. [PMID: 28238253 PMCID: PMC5383112 DOI: 10.5056/jnm16183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/19/2016] [Accepted: 01/08/2017] [Indexed: 12/22/2022] Open
Abstract
There is an unmet need for effective pharmacological therapies for constipation, a symptom that significantly deteriorates patients’ quality of life and impacts health care. Ghrelin is an endogenous ligand for the growth hormone secretagogue receptor and has been shown to exert prokinetic effects on gastrointestinal (GI) motility via the vagus and pelvic nerves. The pharmacological potential of ghrelin is hampered by its short half-life. Ghrelin receptor (GRLN-R) agonists with enhanced pharmacokinetics were thus developed. Centrally penetrant GRLN-R agonists stimulate defecation and improve impaired lower GI transit in animals and humans. This review summarizes the current knowledge on relamorelin, a potent ghrelin mimetic, and other GRLN-R analogs which are in preclinical or clinical stages of development for the management of disorders with underlying GI hypomotility, like constipation.
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Affiliation(s)
- Paula Mosińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Martin Storr
- Center of Endoscopy, Starnberg, Germany and Walter-Brendel-Centre, Ludwig-Maximilians University Munich, Munich, Germany
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
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22
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Siczek K, Zatorski H, Chmielowiec-Korzeniowska A, Kordek R, Tymczyna L, Fichna J. Evaluation of anti-inflammatory effect of silver-coated glass beads in mice with experimentally induced colitis as a new type of treatment in inflammatory bowel disease. Pharmacol Rep 2017; 69:386-392. [PMID: 28267639 DOI: 10.1016/j.pharep.2017.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent studies point at the anti-inflammatory action of silver through induction of apoptosis of inflammatory cells via oxidative stress, promotion of wound healing as well as antimicrobial effect. Our aim was to design a new formulation based on silver and validate its anti-inflammatory activity in the mouse models of colitis. METHODS Silver-coated glass beads were prepared using a magnetron sputtering method and a standard magnetron sputtering gun equipped with pure silver target. Colitis was induced by the ic administration of TNBS into colon (to mimic Crohn's disease) and addition of DSS to drinking water (to imitate ulcerative colitis). Evaluation of inflammation was performed based on macroscopic and microscopic scoring, quantification of the myeloperoxidase activity and colonic microflora analysis. RESULTS Silver-coated glass beads administered ic alleviated intestinal inflammation in mouse models of colitis, induced by TNBS and DSS. This alleviation of colitis resulted principally from changes in the gut microflora. The anti-inflammatory action of the new formulation was associated predominantly with the presence of the silver nanolayer on the beads, and to a lesser extent the size of glass polymer units. CONCLUSIONS The application of the newly developed formulation employing silver-coated glass beads has the potential to be translated to clinical conditions for the efficient treatment of IBD.
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Affiliation(s)
- Krzysztof Siczek
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland; Department of Vehicles and Fundamentals of Machine Design, Faculty of Mechanical Engineering, Lodz University of Technology, Łódź, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Anna Chmielowiec-Korzeniowska
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Radzisław Kordek
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Leszek Tymczyna
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland.
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Siczek K, Zatorski H, Chmielowiec-Korzeniowska A, Pulit-Prociak J, Śmiech M, Kordek R, Tymczyna L, Banach M, Fichna J. Synthesis and evaluation of anti-inflammatory properties of silver nanoparticle suspensions in experimental colitis in mice. Chem Biol Drug Des 2016; 89:538-547. [PMID: 27696734 DOI: 10.1111/cbdd.12876] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 12/24/2022]
Abstract
The aim of our study was to investigate the effect of newly developed silver nanoparticle aqueous suspensions NanoAg1 and NanoAg2 in the mouse models mimicking ulcerative colitis and Crohn's disease. NanoAg1 and NanoAg2 were synthesized in aqueous medium with the involvement of tannic acid. To elucidate their anti-inflammatory activity, semi-chronic mouse models of inflammation induced by dextrane sulfate sodium addition to drinking water and intracolonic (i.c.) administration of 2,4,6-trinitrobenzenesulfonic acid were used. NanoAg1 and NanoAg2 (500 mg/dm3, 100 μl/animal, i.c., once daily) significantly ameliorated colitis in dextrane sulfate sodium- and 2,4,6-trinitrobenzenesulfonic acid-induced mouse models of colonic inflammation, as indicated by reduced macroscopic, ulcer and microscopic scores. The anti-inflammatory effect was dependent on the shape and diameter of silver nanoparticles, as indicated by weaker effect of NanoAg1 than NanoAg2. In addition, administration of NanoAg2, but not NanoAg1, modulated colonic microbiota, as indicated by reduced number of Escherichia coli and Clostridium perfringens, and increased number of Lactobacillus sp. Summarizing, NanoAg1 and NanoAg2 after administered i.c. effectively alleviate colitis in experimental models of ulcerative colitis and Crohn's disease in mice. Therefore, NanoAg1 and NanoAg2 administered i.c. have the potential to become valuable agents for the treatment of inflammatory bowel diseases.
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Affiliation(s)
- Krzysztof Siczek
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.,Department of Vehicles and Fundamentals of Machine Design, Faculty of Mechanics, Lodz University of Technology, Lodz, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Anna Chmielowiec-Korzeniowska
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Jolanta Pulit-Prociak
- Institute of Chemistry and Inorganic Technology, Cracow University of Technology, Cracow, Poland
| | - Magdalena Śmiech
- Institute of Genetics and Animal Breeding, Polish Academy of Sciences, Jastrzebiec, Poland
| | - Radzisław Kordek
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Leszek Tymczyna
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Marcin Banach
- Institute of Chemistry and Inorganic Technology, Cracow University of Technology, Cracow, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
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Zatorski H, Marynowski M, Fichna J. Is insulin-like growth factor 1 (IGF-1) system an attractive target inflammatory bowel diseases? Benefits and limitation of potential therapy. Pharmacol Rep 2016; 68:809-15. [PMID: 27117379 DOI: 10.1016/j.pharep.2016.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/12/2016] [Accepted: 03/04/2016] [Indexed: 01/26/2023]
Abstract
Inflammatory bowel diseases (IBD) are chronic gastrointestinal disorders with unknown etiology, whose incidence dramatically increased over the past 50 years. Currently available strategies for IBD treatment, such as biological therapies, corticosteroids, and immunosuppressive agents are effective, but their side effects and economic costs cannot be ignored. Better understanding of IBD etiology and new therapeutics are thus needed. The aim of this paper is to briefly discuss IGF-1 dependent functions, with particular focus on IGF-1 use in IBD therapy. Data collection was based on records found in medical literature. Data analysis included records published between 1984 and 2014. The IGF-1 system is involved in major physiological functions, such as cell proliferation and metabolism, and growth promotion. Most importantly IGF-1 has anti-inflammatory properties and its use in IBD treatment can be recommended. However, potential IGF-1 therapy has some limitations, which include aggravation of fibrosis in Crohn's patients and facilitated transformation to malignancy. Taken into consideration their possible side effects, IGF-1 analogs and recombinants are nonetheless a promising target for IBD therapy for a specific group of patients. Further studies, at the clinical level are thus recommended.
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Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Mateusz Marynowski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland.
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Siczek K, Zatorski H, Fichna J. Silver and Other Metals in the Treatment of Gastrointestinal Diseases. Curr Med Chem 2015; 22:3695-706. [DOI: 10.2174/0929867322666151001121439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 08/28/2015] [Accepted: 09/29/2015] [Indexed: 11/22/2022]
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Marynowski M, Likońska A, Zatorski H, Fichna J. Role of environmental pollution in irritable bowel syndrome. World J Gastroenterol 2015; 21:11371-11378. [PMID: 26523104 PMCID: PMC4616213 DOI: 10.3748/wjg.v21.i40.11371] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/28/2015] [Accepted: 09/14/2015] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS), with the prevalence of 10%-20 % of the population has become an emerging problem worldwide. IBS is a functional gastrointestinal (GI) disorder characterized by abdominal pain or discomfort and altered bowel habits. The etiology of IBS contains genetic, psychological, and immunological factors, and has not been fully elucidated; of note, recent studies also point at environmental pollution and its role in the development of functional GI diseases. In this review we focus on several environmental factors, such as bacterial contamination, air pollution, radiation and even stress as potential triggers of IBS. We discuss associated disturbances in homeostasis, such as changes in intestinal microbiome and related pathophysiological mechanisms. Based on the effect of environmental factors on the GI tract, we also propose novel targets in IBS treatment.
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Abstract
OPINION STATEMENT Inflammatory bowel diseases (IBD) are a group of chronic inflammatory gastrointestinal (GI) disorders, mainly represented by Crohn's disease and ulcerative colitis. Although the etiology of IBD is not fully understood, there is substantial evidence that immunologic, genetic, and environmental factors are the main contributors in IBD pathogenesis. Conventional therapies for IBD include anti-inflammatory and immunosuppressive drugs, such as 5-aminosalicylic acid, corticosteroids, antibiotics, and biologicals, such as anti-TNFα antibodies. However, because of low efficacy and high risk of side effects, there is a clear need for the development of novel and efficient pharmacologic strategies in IBD treatment. Among various complementary and alternative medicine (CAM) approaches, which are used for the treatment of gastrointestinal (GI) disorders, traditional Chinese medicine (TCM) is one of the most developed and diversified. TCM encompasses methods and therapies that emerged over centuries and is based mostly on ethnic wisdom and observations transmitted from generation to generation. In the recent years, the efficacy of TCM as treatment of IBD has been extensively characterized in preclinical and clinical studies, which resulted in a significant number of research reports. Moreover, the popularity of TCM among patients with IBD has rapidly increased not only in Asia, but also in the Western hemisphere.
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Affiliation(s)
- Maciej Sałaga
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland
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Zatorski H, Sałaga M, Zielińska M, Fichna J. [Genetic factors in pathogenesis, course and treatment of inflammatory bowel diseases]. ACTA ACUST UNITED AC 2015; 69:335-44. [PMID: 25811470 DOI: 10.5604/17322693.1145172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inflammatory bowel diseases (IBD) are a group of chronic gastrointestinal disorders with alternating relapses and remissions. Two main types within IBD can be distinguished: Crohn's disease and ulcerative colitis. Considering the epidemiological, immunological and genetic data, it was concluded that IBD possess multifactorial etiology, where genetic and environmental factors form the immunological background for the disease. In this review we discuss the most important genes and their protein products in IBD etiology and their impact on IBD pharmacotherapy.
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Affiliation(s)
- Hubert Zatorski
- Zakład Biochemii, Wydział Lekarski, Uniwersytet Medyczny w Łodzi
| | - Maciej Sałaga
- Zakład Biochemii, Wydział Lekarski, Uniwersytet Medyczny w Łodzi
| | - Marta Zielińska
- Zakład Biochemii, Wydział Lekarski, Uniwersytet Medyczny w Łodzi
| | - Jakub Fichna
- Zakład Biochemii, Wydział Lekarski, Uniwersytet Medyczny w Łodzi
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Zatorski H, Sałaga M, Zielińska M, Piechota-Polańczyk A, Owczarek K, Kordek R, Lewandowska U, Chen C, Fichna J. Experimental colitis in mice is attenuated by topical administration of chlorogenic acid. Naunyn Schmiedebergs Arch Pharmacol 2015; 388:643-51. [PMID: 25743575 PMCID: PMC4438256 DOI: 10.1007/s00210-015-1110-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/22/2015] [Indexed: 12/19/2022]
Abstract
Epidemiological data suggest that the consumption of polyphenol-rich foods reduces the incidence of cancer, coronary heart disease, and inflammation. Chlorogenic acid (CGA), an ester of caffeic and quinic acids, is one of the most abundant polyphenol compounds in human diet with proven biological effectiveness both in vitro and in vivo. The aim of the study is to investigate the possible anti-inflammatory effect of CGA in the gastrointestinal (GI) tract and its mechanism of action. We used a well-established model of colitis, induced by intracolonic (i.c.) administration of trinitrobenzenesulfonic acid (TNBS) in mice. The anti-inflammatory effect of CGA in the colon was evaluated based on the clinical and macroscopic and microscopic parameters. To investigate the mechanism of protective action of CGA, myeloperoxidase (MPO), H2O2, and NF-κB levels were assessed in the colon tissue. CGA administered i.c. at the dose of 20 mg/kg (two times daily) protected against TNBS-induced colitis more effectively than the same dose administered orally (p.o.), as evidenced by significantly lower macroscopic and ulcer scores. Furthermore, CGA (20 mg/kg, i.c.) reduced neutrophil infiltration, as demonstrated by decreased MPO activity. Moreover, CGA suppressed activation of NF-κB, as evidenced by lower levels of phospho-NF-κB/NF-κB ratio in the tissue. CGA did not affect the oxidative stress pathways. CGA exhibits anti-inflammatory properties through reduction of neutrophil infiltration and inhibition of NF-κB-dependent pathways. Our results suggest that CGA may have the potential to become a valuable supplement in the treatment of GI diseases.
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Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland
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Siczek K, Zatorski H, Pawlak W, Fichna J. Rhenium-coated glass beads for intracolonic administration attenuate TNBS-induced colitis in mice: Proof-of-Concept Study. Folia Med Cracov 2015; 55:49-57. [PMID: 26867119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In search for novel effective treatments in inflammatory bowel diseases, a new strategy employing glass beads coated with rhenium nanolayer has been developed and validated in the mouse model of 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. Briefly, mice were randomly divided into 5 experimental groups: control (vehicle alone, Group 1); control treated with rhenium-coated glass beads (Group 2); TNBS (Group 3); TNBS treated with rhenium-coated glass beads (Group 4); and TNBS treated with uncoated glass beads (Group 5). Mice from Group 2, 4 and 5 were treated with respective beads (once daily, 5 beads / animal, i.c.) between D3-D6 post-TNBS/vehicle and evaluation of colonic damage was performed on D7, based on macroscopic scoring and clinical parameters. Severe colonic inflammation developed in post-TNBS mice (Group 3) [P <0.001 vs. control (Group 1) for macroscopic score], which was significantly attenuated by treatment with rhenium-coated glass beads (Group 4) [P <0.01 vs. TNBS (Group 3), for macroscopic score]. Neither rhenium-coated glass beads had any effect in control animals (Group 2), nor uncoated glass beads influenced TNBS-induced colitis (Group 5). In conclusion, a novel and attractive strategy for the treatment of colonic inflammation has been proposed; therapy with rhenium-coated glass beads already proved effective in the mouse model of TNBS-induced colitis, now requires further characterization in clinical conditions.
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Affiliation(s)
- Krzysztof Siczek
- Department of Vehicles and Fundamentals of Machine Design, Lodz University of Technology, Lodz, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | | | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
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Zatorski H, Fichna J. What is the Future of the Gut Microbiota-Related Treatment? Toward Modulation of Microbiota in Preventive and Therapeutic Medicine. Front Med (Lausanne) 2014; 1:19. [PMID: 25705630 PMCID: PMC4335382 DOI: 10.3389/fmed.2014.00019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 06/26/2014] [Indexed: 12/13/2022] Open
Affiliation(s)
- Hubert Zatorski
- Department of Biochemistry, Medical University of Lodz , Lodz , Poland
| | - Jakub Fichna
- Department of Biochemistry, Medical University of Lodz , Lodz , Poland
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Sobczak M, Fabisiak A, Murawska N, Wesołowska E, Wierzbicka P, Wlazłowski M, Wójcikowska M, Zatorski H, Zwolińska M, Fichna J. Current overview of extrinsic and intrinsic factors in etiology and progression of inflammatory bowel diseases. Pharmacol Rep 2014; 66:766-75. [PMID: 25149979 DOI: 10.1016/j.pharep.2014.04.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/29/2014] [Accepted: 04/09/2014] [Indexed: 12/16/2022]
Abstract
Inflammatory bowel diseases (IBD) are chronic, relapsing disorders affecting gastrointestinal (GI) tract and associated with intestinal mucosa damage and inflammation. The principal therapeutic goals in IBD include control of the intestinal inflammation and treatment of the major symptoms, mainly abdominal pain and diarrhea. Current therapeutic strategies for IBD rely on the use of non-specific anti-inflammatory agents and immunosuppressive drugs (e.g. aminosalicylates, monoclonal antibodies, and antibiotics), which cause severe side effects, and - in a significant number of patients - do not induce long-term benefits. In this review, we summarize the epidemiology and the most important risk factors of IBD, including genetic, immunological and environmental. Our main focus is to discuss pharmacological targets for current and future treatments of IBD.
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Affiliation(s)
- Marta Sobczak
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Adam Fabisiak
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Natalia Murawska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Ewelina Wesołowska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Paulina Wierzbicka
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Marcin Wlazłowski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Marta Wójcikowska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Marta Zwolińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland.
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Fichna J, Sałaga M, Stuart J, Saur D, Sobczak M, Zatorski H, Timmermans JP, Bradshaw HB, Ahn K, Storr MA. Selective inhibition of FAAH produces antidiarrheal and antinociceptive effect mediated by endocannabinoids and cannabinoid-like fatty acid amides. Neurogastroenterol Motil 2014; 26:470-81. [PMID: 24460851 DOI: 10.1111/nmo.12272] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 11/08/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND The endogenous cannabinoid system (ECS) plays a crucial role in multiple physiological processes in the central nervous system and in the periphery. The discovery that selective cannabinoid (CB) receptor agonists exert a potent inhibitory action on gastrointestinal (GI) motility and pain has placed the ECS in the center of attention as a possible target for the treatment of functional GI diseases. However, side effects of CB agonists prompted the search for novel therapeutic targets. Here, the effect of PF-3845, a potent and selective fatty acid amide hydrolase (FAAH) inhibitor in the GI tract was investigated. METHODS The effect of PF-3845 on GI motility was characterized in vitro and in vivo, using mouse models that mimic physiological and pathophysiological conditions. The antinociceptive action of PF-3845 was evaluated on the basis of behavioral pain models. Endocannabinoid degradation product levels after inhibition of FAAH were quantified using HPLC-MS/MS. KEY RESULTS PF-3845 significantly inhibited mouse colonic motility in vitro and in vivo. Selective inhibition of FAAH reversed hypermotility and reduced pain in mouse models mimicking functional GI disorders. The effects of PF-3845 were mediated by endogenous CBs and non-CB lipophilic compounds via classical (CB1) and atypical CB receptors. CONCLUSIONS & INFERENCES These data expand our understanding of the ECS function and provide a novel framework for the development of future potential treatments of functional GI disorders.
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Affiliation(s)
- J Fichna
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada; Department of Biomolecular Chemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
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