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Various laboratory parameters are commonly used to assess the efficacy of biological treatment (BT). The aim of our study was to assess the correlation between platelet (PLT) indices: (mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW)), C-reactive protein (CRP) and endoscopic picture in the course of infliximab induction regimen in ulcerative colitis (UC) patients. The study enrolled 46 patients with UC – 32 men and 16 women. They were administered infliximab (standard induction therapy). Laboratory tests (CRP and PLT indices) and colonoscopy were performed in all patients during the induction regimen – at 0, 2, and 6 weeks and in follow-up six weeks after the completion of induction therapy. The study revealed a statistically significant decrease in CRP and PLT, and an increase in MPV, together with improvement of endoscopic picture (p

Various laboratory parameters are commonly used to assess the efficacy of biological treatment (BT). The aim of our study was to assess the correlation between platelet (PLT) indices: (mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW)), C-reactive protein (CRP) and endoscopic picture in the course of infliximab induction regimen in ulcerative colitis (UC) patients. The study enrolled 46 patients with UC -- 32 men and 16 women. They were administered infliximab (standard induction therapy). Laboratory tests (CRP and PLT indices) and colonoscopy were performed in all patients during the induction regimen -- at 0, 2, and 6 weeks and in follow-up six weeks after the completion of induction therapy. The study revealed a statistically significant decrease in CRP and PLT, and an increase in MPV, together with improvement of endoscopic picture (p <0.001) (MAYO score, MAYO endoscopic subscore) in all patients. PCT and PDW values remained in normal ranges before BT and after the finish of the induction regimen. PCT correlated positively with CRP before the introduction of BT (p = 0.018). In addition, positive correlations between PCT and PLT count were noticed before infliximab induction regimen and in follow-up after the finished of therapy (p <0.001). Additionally, a negative correlation between PLT count and MPV prior to the first dose of infliximab was observed (p=0.032). Our data suggest that PLT indices could be useful biomarkers for determining active UC and for assessing the efficacy of BT. From what we know, this is the first survey devoted to PLT parameters in Polish patients with UC. [ABSTRACT FROM AUTHOR]

Background and Aims The study investigates the practical utility of whole-blood gene expression profiling to diagnose inflammatory bowel diseases [IBDs]. Methods The discovery cohorts included 102 and 51 paediatric IBD patients and controls, and 95 and 46 adult IBD patients and controls, respectively. The replication cohorts included 447 and 76 paediatric IBD patients and controls, and 271 and 108 adult IBD patients and controls, respectively. In the discovery phase, RNA samples extracted from whole peripheral blood were analysed using RNA-Seq, and the predictive values of selected biomarkers were validated using quantitative polymerase chain reaction [qPCR]. Results In all, 15 differentially expressed transcripts [adjusted p ≤0.05] were selected from the discovery sequencing datasets. The receiver operating characteristic curves and area under the curve [ROC-AUC] in replication analyses showed high discriminative power [AUC range, 0.91–0.98] for 11 mRNAs in paediatric patients with active IBD. By contrast, the AUC-ROC values ranged from 0.63 to 0.75 in comparison among inactive paediatric IBDs and active/inactive adult IBDs, indicating a lack of discriminative power. The best multi-mRNA diagnostic classifier showed moderate discriminative power [AUC = 0.81] for paediatric inactive IBD, but was not able to discriminate active or inactive adult IBD patients from controls. The AUC-ROC values did not confirm an ability of the mRNAs abundances to discriminate between active ulcerative colitis and active Crohn's disease in paediatric or adult populations. Conclusions This study identifies and validates blood transcriptional biomarkers that could be used in clinical settings as diagnostic predictors of IBD clinical activity in paediatric, but not adult, IBD patients. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), comprising of ulcerative (UC) colitis and Crohn's disease (CD), are chronic relapsing disorders of unknown etiology. The environmental factors in addition to genetic predisposition are thought to play an important role in the pathogenesis of these diseases. IBD was found to be more common in urban areas than in the rural environment. So far, there have been no reports of the frequency of IBD in Polish rural regions. The aim of the study was to describe the characteristics of IBD in patients from semi-rural and rural regions hospitalized in the Department of Gastroenterology of the Medical University of Lublin between 2000-2006. Methods: A retrospective systematic search of clinical records, identifying cases of inflammatory bowel disease. Results: In the 2000-2006 period of the study, 727 cases of IBD were recorded, of which 334 (46%) originated from semi-rural and rural regions. UC accounted for 69.2% (231 patients) while CD for 30.8% (103 patients). The total number of patients with IBD was higher in the last 3 years (435 patients), compared to 2000-2003 (292 patients). Demographic data, clinical presentation and the location of the disease in patients with IBD from rural and semi-rural regions are similar to patients from urban communities. Conclusion: The rise in hospital admission rates of patients with UC and CD from rural and semi-rural regions confirms the observation of an increasing incidence of IBD in areas, where these diseases were less common in the past. [ABSTRACT FROM AUTHOR]

The highest incidence of inflammatory bowel diseases (IBD) is observed in countries with high socioeconomic rates. Urbanization and good hygienic standards seem to promote higher IBD occurrence. In the last decades, a noticeably higher rate of IBD occurrence can be spotted in countries where social changes related to a western lifestyle took place. A large number of epidemiological studies have shown that people brought up in good sanitary standards were diagnosed with IBD more frequently. One of the ways to explain this phenomenon is the hygiene hypothesis, which implicates that the lack of exposition to germs during childhood years can be linked with the lack of ability to form a proper immunological response to common germs. There is, however, a large amount of studies that do not confirm this hypothesis. A further investigation of this problem is likely to provide us with an explanation why the IBD morbidity in many countries is increasing and may also help with forming proper recommendations how to prevent and treat this disease. [ABSTRACT FROM AUTHOR]

This paper is an update of the diagnostic and therapeutic recommendations of the National Consultant for Gastroenterology and the Polish Society of Gastroenterology from 2013. It contains 49 recommendations for the diagnosis and treatment, both pharmacological and surgical, of ulcerative colitis in adults. The guidelines were developed by a group of experts appointed by the Polish Society of Gastroenterology and the National Consultant in the field of Gastroenterology. The methodology related to the GRADE methodology was used to assess the quality of available evidence and the strength of therapeutic recommendations. The degree of expert support for the proposed statements was assessed on a 6-point Likert scale. Voting results, together with comments, are included with each statement. [ABSTRACT FROM AUTHOR]

Foxp3+CD4+ regulatory T (Treg) cells inhibit immune responses and temper inflammation. IL-17+CD4+ T (Th17) cells mediate inflammation of autoimmune diseases. A small population of IL-17+Foxp3+CD4+ T cells has been observed in peripheral blood in healthy human beings. However, the biology of IL-17+Foxp3+CD4+ T cells remains poorly understood in humans. We investigated their phenotype, cytokine profile, generation, and pathological relevance in patients with ulcerative colitis. We observed that high levels of IL-17+Foxp3+CD4+ T cells were selectively accumulated in the colitic microenvironment and associated colon carcinoma. The phenotype and cytokine profile of IL-17+Foxp3+CD4+ T cells was overlapping with Th17 and Treg cells. Myeloid APCs, IL-2, and TGF-β are essential for their induction from memory CCR6+ T cells or Treg cells. IL-17+Foxp3+CD4+ T cells functionally suppressed T cell activation and stimulated inflammatory cytokine production in the colitic tissues. Our data indicate that IL-17+Foxp3+ cells may be "inflammatory" Treg cells in the pathological microenvironments. These cells may contribute to the pathogenesis of ulcerative colitis through inducing inflammatory cytokines and inhibiting local T cell immunity, and in turn may mechanistically link human chronic inflammation to tumor development. Our data therefore challenge commonly held beliefs of the anti-inflammatory role of Treg cells and suggest a more complex Treg cell biology, at least in the context of human chronic inflammation and associated carcinoma. [ABSTRACT FROM AUTHOR]

Cigarette smoking is a well known independent risk factor for a more severe course of Crohn's disease, but individual factors determining this impact are poorly known and it is not evident if smoking cessation is associated with an improvement in the disease activity. The aim of our study was to assess the factors determining the harmful impact of smoking in individuals with Crohn's disease. A total of 148 consecutive patients with Crohn's disease and Crohn's disease activity index < 200 were enrolled in a prospective 12-18 month study. Patients were classified into three groups as: current smokers, former smokers, and nonsmokers. Body mass index, alcohol consumption, oral contraceptive use and blood lipid levels were also recorded. The main outcome measure was the rate of fare-up. We observed the flare-up developement in 38% current smokers, versus 21% non-smokers and 26% former smokers. The relative risk of flare-up adjusted for confounding factors was 1.37 (1.09 +/- 1.96) in current smokers. Obesity, dyslipidaemia, and alcohol consumption had no significant effect. Current smoking, particularly heavy smoking, significantly increases the risk of flare-up in Crohn's disease patients. Former smokers have a risk similar to that of non-smokers.

Unlabelled: Inflammatory bowel disease (IBD), comprising of ulcerative (UC) colitis and Crohn's disease (CD), are chronic relapsing disorders of unknown etiology. The environmental factors in addition to genetic predisposition are thought to play an important role in the pathogenesis of these diseases. IBD was found to be more common in urban areas than in the rural environment. So far, there have been no reports of the frequency of IBD in Polish rural regions. The aim of the study was to describe the characteristics of IBD in patients from semi-rural and rural regions hospitalized in the Department of Gastroenterology of the Medical University of Lublin between 2000-2006., Methods: A retrospective systematic search of clinical records, identifying cases of inflammatory bowel disease., Results: In the 2000-2006 period of the study, 727 cases of IBD were recorded, of which 334 (46 % ) originated from semi-rural and rural regions. UC accounted for 69.2 % (231 patients) while CD for 30.8 % (103 patients). The total number of patients with IBD was higher in the last 3 years (435 patients), compared to 2000-2003 (292 patients). Demographic data, clinical presentation and the location of the disease in patients with IBD from rural and semi-rural regions are similar to patients from urban communities., Conclusion: The rise in hospital admission rates of patients with UC and CD from rural and semi-rural regions confirms the observation of an increasing incidence of IBD in areas, where these diseases were less common in the past.

In the literature, there are descriptions of single cases of ulcerative colitis (UC) and systemic lupus erythematosus (SLE) coincidence in the same patient. The association of these two autoimmune diseases might be explained by etiopathogenetic factors that they have in common. Recently there have been two patients observed (48 and 31-year old) in whom two and three years (respectively) after diagnosing ulcerative colitis, symptoms of chronic nephropathy showed up (i.e. chronic glomerulonephritis and mild renal failure, respectively). Both of them fulfilled the ACR criteria for SLE. Clinical features and results of laboratory tests allowed the authors to recognize SLE with renal involvement (lupus nephritis in one and nephropathy in the course of secondary antyphospholipid syndrome in the other patient). In both cases drug-induced lupus like syndrome was taken into consideration in differential diagnosis (as both of the patients were previously treated with sulphasalazine) but clinical features and long lasting follow-up after sulphasalazine withdrawal allowed the authors to recognize association of SLE with concomitant nephropathy and UC. In the presented article the problems of differential diagnosis of drug-induced lupus-like syndromes from SLE coexisting with UC are discussed.

Pulmonary complications in patients with ulcerative colitis treated with 5-aminosalicylic acid are infrequent adverse events. The authors present a 35-year-old man, taking sulfasalazine and mesalazine in whom pulmonary abnormalities resembling tuberculosis were observed during several months of therapy. Withdrawal of mesalazine resulted in complete resolution of lung injury. Patient is doing well on maintenance treatment with immunosuppressants