检索结果-南通市图书馆

Colonic ulcerations may predict steroid-refractory course in patients with ipilimumab-mediated enterocolitis

World Journal of Gastroenterology 2017年第11期23卷 2023-2028页

作者： Animesh Jain Evan J Lipson William H Sharfman steven r brant Mark G Lazarev Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of North Carolina Chapel Hill Department of Oncology Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center Division of Gastroenterology and Hepatology Department of Internal MedicineJohns Hopkins University School of Medicine

AIM To investigate management of patients who develop ipilimumab-mediated enterocolitis, including association of endoscopic findings with steroid-refractory symptoms and utility of infliximab as second-line therapy.METHODS We retrospectively reviewed all patients at our centerwith metastatic melanoma who were treated with ipilimumab between March 2011 and May 2014. All patients received a standard regimen of intravenous ipilimumab 3 mg/kg every 3 wk for four doses or until therapy was stopped due to toxicity or disease progression. Basic demographic and clinical data were collected on all patients. For patients who developed grade 2 or worse diarrhea(increase of 4 bowel movements per day), additional data were collected regarding details of gastrointestinal symptoms, endoscopic findings and treatment course. Descriptive statistics were used.rESULTS A total of 114 patients were treated with ipilimumab during the study period and all were included. Sixteen patients(14%) developed ≥ grade 2 diarrhea. All patients were treated with high-dose corticosteroids(1-2 mg/kg prednisone daily or equivalent). Nine of 16 patients(56%) had ongoing diarrhea despite highdose steroids. Steroid-refractory patients received one dose of intravenous infliximab at 5 mg/kg, and all but one had brisk resolution of diarrhea. Fourteen of the patients underwent either colonoscopy or sigmoidoscopy with variable endoscopic findings, ranging from mild erythema to colonic ulcers. Among 8 patients with ulcers demonstrated by sigmoidoscopy or colonoscopy, 7 patients(88%) developed steroidrefractory symptoms requiring infliximab. With a median follow-up of 264 d, no major adverse events associated with prednisone or infliximab were reported.CONCLUSION In patients with ipilimumab-mediated enterocolitis, the presence of colonic ulcers on endoscopy was associated with a steroid-refractory course.

关键词： Ipilimumab Melanoma Enterocolitis Colitis Infliximab Corticosteroid Colonic ulcer

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

role of telomere shortening in anticipation of inflammatory bowel disease

引用

World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第4期11卷 69-78页

作者： Brindusa Truta Elizabeth Wohler Nara Sobreira Lisa W.Datta steven r.brant Division of Gastroenterology&Hepatology Johns Hopkins University School of MedicineBaltimoreMD 21210United States School of Medicine BaltimoreMD 21205United States Department of Medicine Rutgers-Robert Wood Johnson Medical SchoolNJ08901United States

BACKGrOUND The existence of genetic anticipation has been long disputed in inflammatory bowel disease(IBD)in the absence of the explanatory mechanism.AIM To determine whether it was predictive of genetic anticipation,we evaluated telomere length in IBD.We hypothesized that multiplex IBD families exhibit a genetic defect impacting telomere maintenance mechanisms.METHODS We studied three IBD families with multiple affected members in three successive generations.We determined telomere length(TL)in lymphocytes and granulocytes from peripheral blood of the affected members using flow cytometry and fluorescence in-situ hybridization(flow FISH).We also performed whole exome sequencing in the blood of all available family members and used PhenoDB to identify potential candidate gene variants with recessive or dominant modes of inheritance.rESULTS Out of twenty-four patients of European descent selected to participate in the study,eleven patients,eight parent-child pairs affected by IBD,were included in the genetic anticipation analysis.Median difference in age at diagnosis between two successive generations was 16.5 years,with earlier age at onset in the younger generations.In most of the affected members,the disease harbored similar gastrointestinal and extraintestinal involvement but was more aggressive among the younger generations.TL was not associated with earlier age at onset or more severe disease in members of successive generations affected by IBD.NOD2 gene mutations were present in the Crohn’s disease patients of one family.However,no gene variants were identified as potential candidates for inheritance.CONCLUSION Telomere shortening appears unlikely to be involved in mechanisms of possible genetic anticipation in IBD.Further studies using a larger sample size are required to confirm or refute our findings.

关键词： Inflammatory bowel disease Telomere Anticipation Genetic Inheritance

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：