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Cytomegalovirus positive ulcerative colitis:A single center experience and literature review

World Journal of Gastrointestinal Pathophysiology 2013年第1期4卷 18-23页

作者： Uri Kopylov Gila Sasson Bella Geyshis Michal Tepperberg Oikawa Iris Barshack Rami Eliakim Shomron Ben-Horin Department of Gastroenterology Sheba Medical CenterRamat Gan 52621Israel Internal Medicine D Sheba Medical CenterRamat Gan 52621Israel Central Virology Laboratory Public Health LaboratoriesIsrael Ministry of HealthRamat Gan 52621Israel Department of Pathology Sheba Medical CenterRamat Gan 52621Israel

AIM:To compare the clinical outcome of cytomegalovirus(CMV)-positive ulcerative colitis(UC) patients with and without antiviral therapy.METHODS:This was a retrospective case-controlled study.The database of UC patients in our institution was scanned for documented presence of CMV on colonic biopsies.Demographics,clinical data,endoscopy findings and pathology reports were extracted from the patients' charts and electronic records.When available,the data from colonoscopies preceding and following the diagnosis of colonic CMV infection were also ex-tracted.The primary outcomes of the study were colectomy/death during hospitalization and the secondary outcomes were colectomy/death through the course of the follow-up.RESULTS:Thirteen patients were included in the study,7(53.5%) of them were treated with gancyclovir and 6(46.5%) were not.Patients treated with antivirals presented with a more severe disease and 57% of them were treated with cyclosporine or infliximab before initiation of gancyclovir,while none of the patients without antivirals required rescue therapy.One patient died and another patient underwent urgent colectomy during hospitalization,both of them from the gancyclovir-treatment group.For the entire follow-up time(13 ± 13 mo),a total of 3 colectomies and one death occurred,all among the antiviral-treated patients(for colectomy:3/7 vs 0/6 patients,P = 0.19;for combined adverse outcome:4/7 vs 0/6 patients,P = 0.07).In 9/13 patients,immunohistochemistry for CMV was performed on biopsies obtained during a subsequent colonoscopy and was positive in one patient only.CONCLUSION:gancyclovir-treated patients had a more severe disease and outcome,probably unrelated to antiviral therapy.Immunohistochemistry-CMV-positive patients with mild disease may recover without antiviral therapy.

关键词： Ulcerative colitis Cytomegalovirus gancyclovir Cyclosporine Immunohistochemistry

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Phantom of the inflammasome in the gut:Cytomegalovirus

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World Journal of Meta-Analysis 2019年第7期7卷 346-349页

作者： Ferhat Arslan Haluk Vahaboglu Department of Infectious Diseases and Clinical Microbiology Istanbul Medeniyet UniversityIstanbul 34722Turkey

Cytomegalovirus(CMV)is frequently detected in inflammatory bowel tissue,especially in corticosteroid-refractory patients,and it has been blamed for adverse outcomes.However,the first acquisition of CMV does not involve the colon.In particular in the colonic mucosa,which evolved due to the gut microbial relationship,CMV promotes inflammation via recruited monocytes and not through replication in resident macrophages.Whether CMV is the last straw in the process of mucosal inflammation,a doomed agent,or an innocent bystander is a difficult question that remains elusive.With this work,we will try to review the relationship between intestinal mucosa and CMV in the framework of basic virological principles.

关键词： Cytomegalovirus Ulcerative colitis gancyclovir Inflammatory bowel disease

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