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Prognostic role of intestinal ultrasound in Crohn’s disease

World Journal of Gastroenterology 2023年第23期29卷 3595-3605页

作者： Cristina Manzotti Francesco Colombo Tommaso Zurleni piergiorgio danelli Giovanni Maconi Gastroenterology Unit Department of Biomedical and Clinical SciencesUniversity of MilanL.Sacco University HospitalMilano 20157Italy Division of General Surgery Department of Biomedical and Clinical SciencesUniversity of MilanL.Sacco University HospitalMilano 20157Italy

The majority of patients affected by Crohn’s disease(CD)develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel,resulting in stricturing or penetrating complications in around 50%of patients during the natural history of the *** is frequently needed to treat complicated disease when pharmacological therapy failes,with a high risk of repeated operations in *** ultrasound(IUS),a non-invasive,cost-effective,radiation free and reproducible method for the diagnosis and follow-up of CD,in expert hands,allow a precise assessment of all the disease manifestations:Bowel characteristics,retrodilation,wrapping fat,fistulas and ***,IUS is able to assess bowel wall thickness,bowel wall stratification(echo-pattern),vascularization and elasticity,as well as mesenteric hypertrophy,lymph-nodes and mesenteric blood *** role in the disease evaluation and behaviour description is well assessed in literature,but less is known about the potential space of IUS as predictor of prognostic factors suggesting response to a medical treatment or postoperative *** availability of a low cost exam as IUS,able to recognize which patients are more likely to respond to a specific therapy and which patients are at high risk of surgery or complications,could be a very useful instrument in the hands of IBD *** aim of this review is to present current evidence about the prognostic role that IUS can show in predicting response to treatment,disease progression,risk of surgery and risk of post-surgical recurrence in CD.

关键词： Intestinal ultrasound Crohn’s disease Postoperative recurrence Bowel wall thickness Remission Intestinal surgery

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Role of the advanced glycation end products receptor in Crohn's disease inflammation

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World Journal of Gastroenterology 2013年第45期19卷 8269-8281页

作者： Rachele Ciccocioppo Alessandro Vanoli Catherine Klersy Venerina Imbesi Vincenzo Boccaccio Rachele Manca Elena Betti Giuseppina Cristina Cangemi Elena Strada Roberta Besio Antonio Rossi Colomba Falcone Sandro Ardizzone Paolo Fociani piergiorgio danelli Gino Roberto Corazza Department of Internal Medicine Fondazione IRCCS Policlinico San Matteo University of Pavia 27100 Pavia Italy Department of Human Pathology Fondazione IRCCS Policlinico San Matteo University of Pavia 27100 Pavia Italy Biometry and Clinical Epidemiology Unit Fondazione IRCCS Policlinico San Matteo 27100 Pavia Italy Endoscopy Unit Fondazione IRCCS Policlinico San Matteo 27100 Pavia Italy Department of Molecular Medicine University of Pavia 27100 Pavia Italy Center of Research in Molecular Medicine-CIRMC University of Pavia 27100 Pavia Italy IBD Unit Chair and Division of Gastroenterology Luigi Sacco Hospital University of Milan 20157 Milan Italy Department of Pathology Luigi Sacco HospitalUniversity of Milan 20157 Milan Italy Department of Surgery Luigi Sacco Hospital University of Milan 20157 Milan Italy

AIM:To investigate the level of mucosal expression and the involvement of the receptor for the advanced glycation end products(RAGE)in delayed apoptosis and tumor necrosis factor(TNF)-αproduction in Crohn’s disease(CD).METHODS:Surgical and endoscopic specimens from both inflamed and non-inflamed areas of the ileum and/or colon were collected from 20 and 14 adult CD patients,respectively,and used for the assessment of RAGE expression by means of immunohistochemistry and western blotting *** tissues from 21 control subjects were used for *** same polyclonal anti-human RAGE antibody(R and D System)was used in all experimental *** staining was quantized by a score including both the amount of positive cells and intensity of immunoreactivity;cellular pattern was also *** effects of RAGE blocking on apoptotic rate and TNF-αproduction were investigated on immune cells freshly isolated from CD mucosa and incubated both with and without the muramyl dipeptide used as antigenic *** analysis was performed via the test for trend,with regression models to account for intra-patient correlations.A 2-sided P<0.05 was considered ***:In inflamed areas,RAGE expression in both the epithelial and lamina propria compartments was higher than control tissues(P=0.001 and 0.021,respectively),and a cluster of positive cells were usually found in proximity of ulcerative *** results were obtained in the lamina propria compartment of non-inflamed areas(P=0.025).The pattern of staining was membranous and granular cytosolic at the epithelial level,while in the lamina propria it was diffuse *** evaluating the amount of protein expression by immunoblotting,a significant increase of both surface area and band intensity(P<0.0001 for both)was observed in CD inflamed areas compared to control tissue,while in non-inflamed areas a significant increase was found only for band intensity(P<0.005).Moreover,a si

关键词： Apoptosis Crohn’s disease Chronic inflammation Immunohistochemistry Receptor for advanced glycation end products Tumor necrosis factor-α

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