Intestinal Research

Original Articles

Real-world use of biologics during the first year of treatment for newly diagnosed Crohn’s disease in Japan: a claims analysis from 2010 to 2021: Jun Miyoshi, Annabelle Yoon, Minoru Matsuura, Tadakazu Hisamatsu; Received June 5, 2024 Accepted October 5, 2024 Published online January 23, 2025; DOI: https://doi.org/10.5217/ir.2024.00082 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Crohn’s disease (CD) leads to bowel damage and disability if suboptimally treated. We investigated firstyear treatment decisions and real-world use of biologics in patients with CD in Japan.
Methods
In this retrospective observational study (2010–2021) from the JMDC claims database, patients with a new diagnosis of CD (no CD claims record within 12 months before index) who received ≥ 1 pre-defined treatment were grouped by use of biologics and systemic corticosteroids (SCS) within the first year of diagnosis.
Results
Of 823 patients included, 470 (57.1%) were prescribed biologics and 353 (42.9%) were not; 77.6% were male, 75.7% had adult-onset CD, and median age was 24 years. Patients prescribed biologics were younger (median: 23 years vs. 28 years) and more had perianal lesions (43.0% vs. 22.9%) than those not prescribed biologics; 64.9% (95% confidence interval, 60.4%–69.2%) received a top-down treatment approach (no SCS before biologics). Factors significantly associated with a top-down treatment approach were male sex, perianal lesions, no use of immunomodulators, and use of anti-tumor necrosis factor therapies. The proportion of patients receiving SCS before biologics (step-up approach) increased after 2018, with a shift from prednisolone to budesonide from 2016. Persistence with first biologics decreased over time, with no differences between biologic types.
Conclusions
Use of biologics for treatment of CD within the first year of diagnosis in Japan has remained stable over the past decade. However, there was a shift to a step-up treatment approach, with an increase in use of SCS before biologics over time.

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Factors affecting 1-year persistence with vedolizumab for ulcerative colitis: a multicenter, retrospective real-world study: Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Jovelle L. Fernandez, Kaori Ishiguro, Mary Cavaliere, Hisato Deguchi, Toshifumi Hibi; Received May 1, 2024 Accepted October 5, 2024 Published online January 16, 2025; DOI: https://doi.org/10.5217/ir.2024.00063 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
The objectives of this real-world study were to determine 1-year persistence with vedolizumab in patients with ulcerative colitis and to evaluate factors contributing to loss of response.
Methods
In this multicenter, retrospective, observational chart review, patients with moderately to severely active ulcerative colitis who received ≥ 1 dose of vedolizumab in clinical practice at 16 tertiary hospitals in Japan (from December 2018 through February 2020) were enrolled.
Results
Persistence with vedolizumab was 64.5% (n = 370); the median follow-up time was 53.2 weeks. Discontinuation due to loss of response among initial clinical remitters was reported in 12.5% (35/281) of patients. Multivariate analysis showed that concomitant use of tacrolimus (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.00–7.62; P= 0.050) and shorter disease duration (OR for median duration ≥ 7.8 years vs. < 7.8 years, 0.33; 95% CI, 0.13–0.82; P= 0.017) were associated with discontinuation due to loss of response. Loss of response was not associated with prior use of anti-tumor necrosis factor alpha therapy, age at the time of treatment, disease severity, or concomitant corticosteroids or immunomodulators. Of the 25 patients with disease duration < 1 year, 32.0% discontinued due to loss of response.
Conclusions
Persistence with vedolizumab was consistent with previous reports. Use of tacrolimus and shorter disease duration were the main predictors of decreased persistence.

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IBD

Usefulness of fecal calprotectin by monoclonal antibody testing in adult Japanese with inflammatory bowel diseases: a prospective multicenter study: Shiro Nakamura, Hirotsugu Imaeda, Hiroki Nishikawa, Masaki Iimuro, Minoru Matsuura, Hideo Oka, Junsuke Oku, Takako Miyazaki, Hirohito Honda, Kenji Watanabe, Hiroshi Nakase, Akira Andoh; Intest Res 2018;16(4):554-562. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00027

Abstract PDF PubReader ePub

Background/Aims
Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of fecal FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody.
Methods
We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64).
Results
FCP levels in UC patients strongly correlated with the Disease Activity Index (rs=0.676, P<0.0001) and Mayo endoscopic subscore (MES; rs=0.677, P<0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P<0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P<0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs=0.283, P=0.0565).
Conclusions
Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC.

Citations

Citations to this article as recorded by

Combining mechanistic modeling with machine learning as a strategy to predict inflammatory bowel disease clinical scores
Jaehee V. Shim, Markus Rehberg, Britta Wagenhuber, Piet H. van der Graaf, Douglas W. Chung
Frontiers in Pharmacology.2025;[Epub] CrossRef
Treatment escalation and de-escalation decisions in Crohn’s disease: Delphi consensus recommendations from Japan, 2021
Hiroshi Nakase, Motohiro Esaki, Fumihito Hirai, Taku Kobayashi, Katsuyoshi Matsuoka, Minoru Matsuura, Makoto Naganuma, Masayuki Saruta, Kiichiro Tsuchiya, Motoi Uchino, Kenji Watanabe, Tadakazu Hisamatsu, Akira Andoh, Shigeki Bamba, Motohiro Esaki, Mikihi
Journal of Gastroenterology.2023; 58(4): 313. CrossRef
Mucosal concentrations of N‐acetyl‐5‐aminosalicylic acid related to endoscopic activity in ulcerative colitis patients with mesalamine
Tomohiro Fukuda, Makoto Naganuma, Kaoru Takabayashi, Yuya Hagihara, Shun Tanemoto, Ena Nomura, Yusuke Yoshimatsu, Shinya Sugimoto, Kosaku Nanki, Shinta Mizuno, Yohei Mikami, Kayoko Fukuhara, Tomohisa Sujino, Makoto Mutaguchi, Nagamu Inoue, Haruhiko Ogata,
Journal of Gastroenterology and Hepatology.2020; 35(11): 1878. CrossRef
Clinical management for small bowel of Crohn’s disease in the treat-to-target era: now is the time to optimize treatment based on the dominant lesion
Kenji Watanabe
Intestinal Research.2020; 18(4): 347. CrossRef

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Maternal and fetal outcomes in pregnant Japanese women with inflammatory bowel disease: our experience with a series of 23 cases: Naoki Minami, Minoru Matsuura, Yorimitsu Koshikawa, Satoshi Yamada, Yusuke Honzawa, Shuji Yamamoto, Hiroshi Nakase; Intest Res 2017;15(1):90-96. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.90

Abstract PDF PubReader ePub

Background/Aims

Our physicians work to expand the possibilities to treat female patients with inflammatory bowel disease (IBD) who wish to become pregnant. Although many drugs, including 5-aminosalicylate (5-ASA), corticosteroids, immunomodulators, and biologics, are used safely during pregnancy, few reports have described the therapeutic regimen throughout pregnancy and the management of patients who relapse during pregnancy precisely. The aim of this study was to assess the management of patients with IBD during pregnancy.

Methods

We identified 19 patients (five with Crohn's disease and 14 with ulcerative colitis [UC]) who became pregnant with a total of 23 pregnancies between May 2005 and May 2015 by reviewing the medical records of Kyoto University Hospital. The following data were collected: the maternal variables, the IBD treatment type, the disease activity, the pregnancy outcome, and the mode of delivery.

Results

Among the 19 patients, 18 had become pregnant after being diagnosed with IBD, while one had developed UC newly after pregnancy. Throughout the gestation, all patients were treated with probiotics, 5-ASA, prednisolone, cytapheresis, or infliximab. The relapse rate during pregnancy was 21.7% (5/23 cases). The five patients who experienced a relapse were able to pursue their pregnancy after intensification of their treatments. There were no adverse fetal or neonatal problems, except in one case that required an emergency Caesarean section because of placental dysfunction and in which a very low-birth-weight infant was born preterm.

Conclusions

Our present data confirmed that even if the disease flares up during pregnancy, good pregnancy outcomes can be achieved with an optimal intensification of the patient's treatment.

Citations

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The pregnancy outcome and drug usage during pregnancy among Taiwanese inflammatory bowel disease patients
Chen‐Wang Chang, Shu‐Chen Wei, Jen‐Wei Chou, Tien‐Yu Huang, Chia‐Jung Kuo, Wen‐Hung Hsu, Chen‐Shuan Chung, Tzu‐Chi Hsu, Wei‐Chen Lin, Ming‐Jen Chen, Horng‐Yuan Wang
Advances in Digestive Medicine.2023; 10(4): 226. CrossRef
Intrauterine Exposure to Biologics in Inflammatory Autoimmune Diseases: A Systematic Review
N. Ghalandari, R. J. E. M. Dolhain, J. M. W. Hazes, E. P. van Puijenbroek, M. Kapur, H. J. M. J. Crijns
Drugs.2020; 80(16): 1699. CrossRef

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Case Report

Ischemic enteritis with intestinal stenosis: Yorimitsu Koshikawa, Hiroshi Nakase, Minoru Matsuura, Takuya Yoshino, Yusuke Honzawa, Naoki Minami, Satoshi Yamada, Yumiko Yasuhara, Shigehiko Fujii, Toshihiro Kusaka, Dai Manaka, Hiroyuki Kokuryu; Intest Res 2016;14(1):89-95. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.89

Abstract PDF PubReader ePub

A 75-year-old man was admitted to our hospital with sudden onset of vomiting and abdominal distension. The patient was taking medication for arrhythmia. Computed tomography showed stenosis of the ileum and a small bowel dilatation on the oral side from the region of stenosis. A transnasal ileus tube was placed. Enteroclysis using contrast medium revealed an approximately 6-cm afferent tubular stenosis 10 cm from the terminal ileum and thumbprinting in the proximal bowel. Transanal double-balloon enteroscopy showed a circumferential shallow ulcer with a smooth margin and edema of the surrounding mucosa. The stenosis was so extensive that we could not perform endoscopic balloon dilation therapy. During hospitalization, the patient's nutritional status deteriorated. In response, we surgically resected the region of stenosis. Histologic examination revealed disappearance of the mucosal layer and transmural ulceration with marked fibrosis, especially in the submucosal layer. Hemosiderin staining revealed sideroferous cells in the submucosal layers. Based on the pathologic findings, the patient was diagnosed with ischemic enteritis. The patient's postoperative course was uneventful.

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Myeloid Sarcoma in the Small Intestine
Masaya Iwamuro, Tomohiro Kamio, Shoichiro Hirata, Katsunori Matsueda, Daisuke Kametaka, Takehiro Tanaka, Seiji Kawano, Motoyuki Otsuka
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Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report
Taiki Sunakawa, Nobuo Ito, Ryo Moriyasu, Nobuya Seki, Daisuke Takeuchi, Kotaro Sasahara
Surgical Case Reports.2022;[Epub] CrossRef
Ischemic enteritis resulting from polycythemia vera
Soichi Yagi, Kiyohide Kioka, Yurina Koizumi, Takashi Nakai, Yasuko Kawasaki, Minako Tsutsumi, Naomi Ishii, Tomoaki Yamasaki, Hiroko Nebiki, Kiyoshi Maeda
Clinical Journal of Gastroenterology.2022; 15(5): 907. CrossRef
Association of decreased variation of coefficient R–R interval with ischemic colitis and small bowel obstruction
Toshio Arai, Hiroki Yamada, Takeya Edagawa, Satoshi Yoshida, Shigetoshi Hikimoto, Hiromichi Sougawa, Kenichiro Nakachi, Raffaele Serra
PLOS ONE.2020; 15(2): e0228117. CrossRef
Ileítis isquémica idiopática, con sangrado digestivo oscuro manifiesto
Gabriel Mosquera-Klinger, Reinaldo Andrés Rincón
Gastroenterología y Hepatología.2019; 42(7): 439. CrossRef
Small bowel strictures
Deniz Durmush, Arthur J. Kaffes
Current Opinion in Gastroenterology.2019; 35(3): 235. CrossRef
Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture
Andrew Holloway, Mauro Pivetta, Roberta Rasotto
Veterinary Radiology & Ultrasound.2019; 60(4): 423. CrossRef
Experience with Balloon Dilatation in Crohn’s and Non-Crohn’s Benign Small-Bowel Strictures: Is There a Difference?
Akiyoshi Tsuboi, Shiro Oka, Shinji Tanaka, Sumio Iio, Ichiro Otani, Sayoko Kunihara, Ryohei Hayashi, Kazuaki Chayama
Gastroenterology Research and Practice.2019; 2019: 1. CrossRef
Idiopathic ischaemic ileitis, with overt obscure digestive bleeding
Gabriel Mosquera-Klinger, Reinaldo Andrés Rincón
Gastroenterología y Hepatología (English Edition).2019; 42(7): 439. CrossRef
Stenotic Ischemic Enteritis with Concomitant Hepatic Portal Venous Gas and Pneumatosis Cystoides Intestinalis
Naoto Iwai, Osamu Handa, Yuji Naito, Osamu Dohi, Tetsuya Okayama, Naohisa Yoshida, Kazuhiro Kamada, Kazuhiko Uchiyama, Takeshi Ishikawa, Tomohisa Takagi, Hideyuki Konishi, Yoshito Itoh
Internal Medicine.2018; 57(14): 1995. CrossRef
Etiology and long‐term rebleeding of endoscopic ulcerative lesions in the small bowel in patients with obscure gastrointestinal bleeding: A multicenter cohort study
Tomonori Aoki, Atsuo Yamada, Yoshihiro Hirata, Hirobumi Suzuki, Ayako Nakada, Ryota Niikura, Motoko Seto, Makoto Okamoto, Kazuhiko Koike
Journal of Gastroenterology and Hepatology.2018; 33(7): 1327. CrossRef

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Original Articles

Efficacy of Thiopurines in Biologic-Naive Japanese Patients With Crohn's Disease: A Single-Center Experience: Takuya Yoshino, Minoru Matsuura, Naoki Minami, Satoshi Yamada, Yusuke Honzawa, Masamichi Kimura, Yorimitsu Koshikawa, Ali Madian, Takahiko Toyonaga, Hiroshi Nakase; Intest Res 2015;13(3):266-273. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.266

Abstract PDF PubReader

Background/Aims

Early use of biologics in patients with Crohn's disease (CD) improves quality of life. However, the effects of the early use of immunomodulators on long-term outcomes remain unclear. This study aimed to evaluate the effects of immunomodulators in patients with CD.

Methods

Between January 2004 and December 2011, 47 biologic-naive CD patients treated with thiopurines alone for remission maintenance were analyzed. The patients were classified into 2 groups depending on the presence or absence of digestive complications. We evaluated the efficacy of and predictive factors for thiopurine use for remission maintenance.

Results

The cumulative relapse rates at 24 and 60 months were 13.7% and 35.4%, respectively. Regarding patient characteristics, there was a significant difference in patient history of surgery between the non-relapse and relapse groups (P=0.021). The cumulative relapse rate was lower in patients without a history of surgery than in those with such a history (27.2% and 52.9% at 60.0 months, respectively). Multivariate analysis suggested that the prevalence of stricturing and penetrating complications is an independent factor for relapse. The cumulative relapse rate in patients without a history of surgery was significantly lower in the non-stricturing and non-penetrating group than in the stricturing and penetrating group (11.8% at 85.0 months vs. 58.5% at 69.0 months; P=0.036).

Conclusions

Thiopurine use might be beneficial for the long-term maintenance of remission in biologic-naive Crohn's disease patients without digestive complications and a history of surgery.

Citations

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Thiopurines Have Sustained Long-term Effectiveness in Patients with Inflammatory Bowel Disease, Which is Independent of Disease Duration at Initiation: A Propensity Score Matched Analysis
Mukesh Kumar Ranjan, Peeyush Kumar, Sudheer Kumar Vuyyuru, Bhaskar Kante, Sandeep K Mundhra, Rithvik Golla, Shubi Virmani, Raju Sharma, Peush Sahni, Prasenjit Das, Mani Kalaivani, Ashish Datt Upadhyay, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Journal of Crohn's and Colitis.2024; 18(2): 192. CrossRef
Efficacy of drug and endoscopic treatment of Crohn's disease strictures: A systematic review
Julien D Schulberg, Emily K Wright, Bronte A Holt, Helen E Wilding, Amy L Hamilton, Alyson L Ross, Michael A Kamm
Journal of Gastroenterology and Hepatology.2021; 36(2): 344. CrossRef
Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study
Hee Seung Hong, Kyuwon Kim, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Therapeutic Advances in Gastroenterology.2021;[Epub] CrossRef
NUDT15,FTO, andRUNX1genetic variants and thiopurine intolerance among Japanese patients with inflammatory bowel diseases
Toshiyuki Sato, Tetsuya Takagawa, Yoichi Kakuta, Akihiro Nishio, Mikio Kawai, Koji Kamikozuru, Yoko Yokoyama, Yuko Kita, Takako Miyazaki, Masaki Iimuro, Nobuyuki Hida, Kazutoshi Hori, Hiroki Ikeuchi, Shiro Nakamura
Intestinal Research.2017; 15(3): 328. CrossRef
Importance of Patients’ Knowledge of Their Prescribed Medication in Improving Treatment Adherence in Inflammatory Bowel Disease
Chung Hyun Tae, Sung-Ae Jung, Hye Sung Moon, Jung-A Seo, Hye Kyung Song, Chang Mo Moon, Seong-Eun Kim, Ki-Nam Shim, Hye-Kyung Jung
Journal of Clinical Gastroenterology.2016; 50(2): 157. CrossRef

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Efficacy and Safety of Long-Term Thiopurine Maintenance Treatment in Japanese Patients With Ulcerative Colitis: Satoshi Yamada, Takuya Yoshino, Minoru Matsuura, Masamichi Kimura, Yorimitsu Koshikawa, Naoki Minami, Takahiko Toyonaga, Yusuke Honzawa, Hiroshi Nakase; Intest Res 2015;13(3):250-258. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.250

Abstract PDF Supplementary Material PubReader

Background/Aims

The long-term clinical outcomes of patients with bio-naive ulcerative colitis (UC) who maintain remission with thiopurine are unclear. The aim of this study was to assess the long-term efficacy and safety of maintenance treatment with thiopurine in UC patients.

Methods

This was a retrospective observational cohort analysis conducted at a single center. Between December 1998 and August 2013, 59 of 87 patients with bio-naive UC who achieved remission after induction with treatments other than biologics were enrolled. Remission maintenance with thiopurine was defined as no concomitant treatment needed other than 5-aminosalicylate without relapse. We assessed the remission-maintenance rate, mucosal healing rate, colectomy-free rate, and treatment safety in UC patients who received thiopurine as maintenance treatment.

Results

The 84-month cumulative remission-maintenance and colectomy-free survival rates in the UC patients who were receiving maintenance treatment with thiopurine and 5-aminosalicylate were 43.9% and 88.0%, respectively. Of the 38 patients who underwent colonoscopy during thiopurine maintenance treatment, 23 (60.5%) achieved mucosal healing. Of the 59 patients who achieved clinical remission with thiopurine, 6 patients (10.2%) discontinued the thiopurine therapy because of adverse events.

Conclusions

Our study demonstrates the long-term efficacy and safety of thiopurine treatment in patients with bio-naive UC.

Citations

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Thiopurines Have Sustained Long-term Effectiveness in Patients with Inflammatory Bowel Disease, Which is Independent of Disease Duration at Initiation: A Propensity Score Matched Analysis
Mukesh Kumar Ranjan, Peeyush Kumar, Sudheer Kumar Vuyyuru, Bhaskar Kante, Sandeep K Mundhra, Rithvik Golla, Shubi Virmani, Raju Sharma, Peush Sahni, Prasenjit Das, Mani Kalaivani, Ashish Datt Upadhyay, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Journal of Crohn's and Colitis.2024; 18(2): 192. CrossRef
Potential benefits of immunomodulator use with vedolizumab for maintenance of remission in ulcerative colitis
Makoto Naganuma, Kenji Watanabe, Satoshi Motoya, Haruhiko Ogata, Toshiyuki Matsui, Yasuo Suzuki, Lyann Ursos, Shigeru Sakamoto, Mitsuhiro Shikamura, Tetsuharu Hori, Jovelle Fernandez, Mamoru Watanabe, Toshifumi Hibi, Takanori Kanai
Journal of Gastroenterology and Hepatology.2022; 37(1): 81. CrossRef
Real-World Long-Term Remission Maintenance for 10 Years With Thiopurines in Ulcerative Colitis
Satohiro Matsumoto, Hirosato Mashima
Crohn's & Colitis 360.2021;[Epub] CrossRef
Treatment of Inflammatory Bowel Disease: A Comprehensive Review
Zhaobei Cai, Shu Wang, Jiannan Li
Frontiers in Medicine.2021;[Epub] CrossRef
Optimizing the Use of Current Treatments and Emerging Therapeutic Approaches to Achieve Therapeutic Success in Patients with Inflammatory Bowel Disease
Hiroshi Nakase
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The Leading Edge of the Treatment of Inflammatory Bowel Disease
Hiroshi Nakase
Nihon Naika Gakkai Zasshi.2020; 109(6): 1145. CrossRef
Predictive Role of NUDT15 Variants on Thiopurine-Induced Myelotoxicity in Asian Inflammatory Bowel Disease Patients
Natalia Sutiman, Sylvia Chen, Khoon Lin Ling, Sai Wei Chuah, Wai Fook Leong, Vinayak Nadiger, Madeline Tjai, Chris San Choon Kong, Brian John Schwender, Webber Chan, Hang Hock Shim, Wee Chian Lim, Chiea Chuen Khor, Yin Bun Cheung, Balram Chowbay
Pharmacogenomics.2018; 19(1): 31. CrossRef
NUDT15,FTO, andRUNX1genetic variants and thiopurine intolerance among Japanese patients with inflammatory bowel diseases
Toshiyuki Sato, Tetsuya Takagawa, Yoichi Kakuta, Akihiro Nishio, Mikio Kawai, Koji Kamikozuru, Yoko Yokoyama, Yuko Kita, Takako Miyazaki, Masaki Iimuro, Nobuyuki Hida, Kazutoshi Hori, Hiroki Ikeuchi, Shiro Nakamura
Intestinal Research.2017; 15(3): 328. CrossRef
Clinical Efficacy of Beclomethasone Dipropionate in Korean Patients with Ulcerative Colitis
Yoon Jee Lee, Jae Hee Cheon, Jae Hyun Kim, SunHo Yoo, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim
Yonsei Medical Journal.2017; 58(1): 144. CrossRef
Rate and Predictors of Mucosal Healing in Ulcerative Colitis Treated with Thiopurines: Results of a Multicentric Cohort Study
Caroline Prieux-Klotz, Stéphane Nahon, Aurelien Amiot, Leila Sinayoko, Carole Galéano-Cassaz, Stanislas Chaussade, Romain Coriat, Pierre Lahmek, Vered Abitbol
Digestive Diseases and Sciences.2017; 62(2): 473. CrossRef
Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission
Jae Hyun Kim, Jae Hee Cheon, Yehyun Park, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim
Scandinavian Journal of Gastroenterology.2016; 51(9): 1069. CrossRef
Is Long-Term Therapy With Thiopurines Effective for Maintaining Remission in Patients With Moderate-To-Severe Ulcerative Colitis?
Seong Ran Jeon, Won Ho Kim
Intestinal Research.2015; 13(3): 191. CrossRef

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Case Report

Usefulness of Adalimumab for Treating a Case of Intestinal Behçet's Disease With Trisomy 8 Myelodysplastic Syndrome: Masamichi Kimura, Yoshihisa Tsuji, Masako Iwai, Masahiro Inagaki, Ali Madian, Takuya Yoshino, Minoru Matsuura, Hiroshi Nakase; Intest Res 2015;13(2):166-169. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.166

Abstract PDF PubReader

Behçet's disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-α is strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-α plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-α antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab.

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Jeerthi Kannan, Liza Mathews, Zhijie Wu, Neal S. Young, Shouguo Gao
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Claudio Fozza, Andrea Murtas, Giovanni Caocci, Giorgio La Nasa
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Yehyun Park, Jae Hee Cheon
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How to treat myelodysplastic syndrome with clinical features resembling Behçet syndrome: a case-based systematic review
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Evidence-based diagnosis and clinical practice guidelines for intestinal Behçet’s disease 2020 edited by Intractable Diseases, the Health and Labour Sciences Research Grants
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Diagnosis and Treatment of Ulcerative Colitis with Cytomegalovirus Infection: Importance of Controlling Mucosal Inflammation to Prevent Cytomegalovirus Reactivation: Hiroshi Nakase, Yusuke Honzawa, Takahiko Toyonaga, Satoshi Yamada, Naoki Minami, Takuya Yoshino, Minoru Matsuura; Intest Res 2014;12(1):5-11. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.5

Abstract PDF PubReader

Human cytomegalovirus (HCMV) is a member of the herpesvirus family. HCMV infection persists throughout the host lifespan in a latent state following primary infection. The ability of HCMV to escape control by the host immune system and its resulting reactivation suggests the importance of ongoing immune surveillance in the prevention of HCMV reactivation. HCMV is a common cause of opportunistic infection that causes severe and fatal disease in immune-compromised individuals. In inflammatory bowel disease patients, particularly those with ulcerative colitis (UC), HCMV is often reactivated because these patients are frequently treated with immunosuppressive agents. This reactivation exacerbates colitis. Additionally, HCMV infection can induce severe colitis, even in patients with UC who have never been treated with immunosuppressive agents. However, the role of HCMV in colonic inflammation in patients with UC remains unclear. Here, we present previous and current clinical data on the diagnosis and treatment of HCMV infection in UC. Additionally, our experimental data from a newly established mouse model mimicking UC with concomitant CMV infection clearly demonstrate that inflammation could result in the exacerbation of UC disease activity with induction of HCMV reactivation. In summary, optimal control of colonic inflammation should be achieved in UC patients who are refractory to conventional immunosuppressive therapies and are positive for HCMV.

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Role of the CXC12-CXCR4 Axis and CXCL16 in Inflammatory Bowel Disease: Hiroshi Nakase, Minoru Matsuura, Sakae Mikami, Norimitsu Uza, Tsutomu Chiba; Intest Res 2012;10(2):125-133. Published online April 30, 2012; DOI: https://doi.org/10.5217/ir.2012.10.2.125

Abstract PDF

Numerous studies of colitis in IBD (inflammatory bowel diseases) patients and in animal models have demonstrated that both inflammatory cytokines and chemokines are up-regulated in settings of active inflammation. Blockade or absence of various cytokines and chemokines attenuates the disease in murine models of IBD. Therefore, identifying cytokines and chemokines involved in intestinal inflammation provide promising targets for the development of new drugs in the treatment of IBD. In general, chemokines have been implicated in many fundamental immune processes including lymphoid organogenesis, immune cell differentiation, development and positioning. Many chemokines are markedly increased in intestinal tissue from patients with IBD. In this study, we focused on the role of CXCL12-CXCR4 and CXCL16. CXCL12-CXCR4 axis plays a crucial role in the pathophysiology of IBD, especially UC, while SR-PSOX/CXCL16 plays a significant role in the pathophysiology of CD. Our present data suggest new insights into the etiology of IBD and we hope that the manipulation of these chemokines may have therapeutic value. (Intest Res 2012;10:125-133)

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