Link Between Skin Disease Hidradenitis Suppurativa and Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Hidradenitis suppurativa- DermNetNZ

Hidradenitis suppurativa- DermNetNZ

Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford)
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Guishan Dist, Taoyuan 33305
Taiwan

MedicalResearch.com: What is the background for this study?

Response: Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) are inflammatory diseases that share common clinical manifestations, genetic susceptibility, and immunologic features. For example, both diseases have similar clinical manifestations in the skin and gut, characterized by sterile abscesses in perineal and inguinal areas, scarring, and sinus tract formation. Both diseases have been associated with an increased prevalence of spondyloarthropathy, have common risk factors (smoking and obesity), and respond well to tumor necrosis factor-inhibitors. Some studies have suggested a link between HS and IBD, but data on the association of HS and IBD remain inconsistent and unclear. Therefore, we conducted a meta-analysis to investigate the association of hidradenitis suppurativ with IBD.

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Ulcerative colitis: Fecal Microbiota Transplantation Can Induce Remission

MedicalResearch.com Interview with:

Samuel P. Costello MBBS Inflammatory Bowel Disease Service, Department of Gastroenterology, The Queen Elizabeth Hospital Australia

Dr. Costello

Samuel P. Costello MBBS
Inflammatory Bowel Disease Service,
Department of Gastroenterology
The Queen Elizabeth Hospital
Australia

MedicalResearch.com: What is the background for this study?

Response: Ulcerative colitis (UC) is an inflammatory bowel disease that has high rates of persistent or relapsing symptoms despite available therapies. Many of these therapies also have the potential for unacceptable side effects including allergy, intolerance, serious infection and malignancy due to long-term immunosuppression. It is for these reasons that new therapies for Ulcerative colitis are required; particularly therapies that target novel pathways and are not immune suppressing.

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Tofacitinib -XELJANZ: Potential New Treatment Option For Moderate To Severe Ulcerative Colitis

MedicalResearch.com Interview with:

William J. Sandborn, MD Professor of Medicine and Adjunct Professor of Surgery Chief, Division of Gastroenterology Vice Chair for Clinical Operations, Department of Medicine Director, UCSD IBD Center University of California San Diego and UC San Diego Health System

Dr. Sandborn

William J. Sandborn, MD
Professor of Medicine and Adjunct Professor of Surgery
Chief, Division of Gastroenterology
Vice Chair for Clinical Operations, Department of Medicine
Director, UCSD IBD Center
University of California San Diego and
UC San Diego Health System

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is still a substantial unmet need for new treatments for patients with ulcerative colitis.

A previous Phase II study had suggested that tofacitinib might be effective for short term therapy of ulcerative colitis. The patients in that study for the most part had not failed anti-TNF therapy. Now we report the findings from 3 large Phase III trials, two short term trials and one long term trial, demonstrating that tofacitinib 10 mg twice daily is effective for short term therapy, and that both 5 mg and 10 mg twice daily is effective for long term therapy. We also demonstrated that tofacitinib is effective both in patients who have not failed anti-TNF therapy and patients who have failed anti-TNF therapy.

The study demonstrated induction of clinical remission, clinical response and mucosal healing (flexible sigmoidoscopy improvement) over the short term, and maintenance of clinical remission, clinical response, and mucosal healing over the long term.

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Fecal Microbiota Transplantation is Promising Option for Ulcerative Colitis Treatment

MedicalResearch.com Interview with:
Dr. Sudarshan Paramsothy

University of New South Wales
Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Paramsothy: This study was conducted as there is strong evidence that the gastrointestinal microbiota play a critical role in the underlying pathogenesis of inflammatory bowel disease (IBD), but treatments to date primarily are focused on controlling the associated immune response. Attempts at therapeutic microbial manipulation in ulcerative colitis (UC) to date (antibiotics, probiotics, prebiotics) have not been as impressive as one might expect. We felt intensive fecal microbiota transplantation (FMT) may be more successful than these other methods, as it involves transplanting the entire gastrointestinal microbiota from a health individual, and thus more likely to correct any underlying microbial disturbance or dysbiosis in the recipient UC patient.

Our study found that significantly more active ulcerative colitis patients treated with intensive FMT than placebo (27% vs 8%) achieved the trial primary composite endpoint of both

  • clinical remission induction (ie resolution of symptoms) and
  • endoscopic remission or response (ie either healing or significant improvement of the bowel lining)

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Hydrogel Will Potentially Coat and Heal Ulcerative Colitis Lesions

MedicalResearch.com Interview with:
Dr. Jeff Karp Ph.D Associate Professor of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge, MA  02139 Dr. Jeff Karp Ph.D
Associate Professor of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Cambridge, MA  02139 and

Giovanni Traverso M.B., B.Ch., Ph.DDr-Giovanni-Traverso
The David H. Koch Institute for Integrative Cancer Research
Massachusetts Institute of Technology, Cambridge, MA

 

Medical Research: What is the background for this study? What are the main findings

Dr. Karp: Almost all patients with ulcerative colitis will require enema-based therapy at some point in their treatment.  Enema therapy has 3 major issues.

  • It is difficult to retain
  • There is high systemic absorption of the drug (that can lead to toxic side effects), and
  • Compliance is low as patients must take enemas every day.

Our approach can potentially address all three.  The engineered gel that we designed has dual targeting capability. It rapidly attaches to ulcers within seconds to minutes (we have 5-10x less systemic absorption as the gel only attaches to ulcers) and selectively releases drug in the presence of ulcers, and we showed that we could reduce the dosing frequency.

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Ulcerative Colitis: Black Raspberries May Decrease Progression to Colon Cancer

Li-Shu Wang, PhD Department of Medicine, Medical College of Wisconsin, Milwaukee, WisconsinMedicalResearch.com Interview with:
Li-Shu Wang, PhD
Department of Medicine, Medical College of Wisconsin,
Milwaukee, Wisconsin
MedicalResearch.com: What are the main findings of the study?

Answer: Ulcerative colitis (UC) is frequently an intermediate step to colon cancer.  The interleukin-10 knock-out (KO) mouse is a genetic model of this progression.  We have now shown that KO mice fed 5% black raspberries (BRBs) had significantly less colonic ulceration as compared to KO mice that consumed the control diet.  Dysfunction of the Wnt signaling pathway is a key event in UC-associated colon carcinogenesis.  We investigated the effects of BRBs on the Wnt pathway and found that the BRB-fed KO mice exhibited significantly decreased promoter methylation of Wnt antagonists and a significantly lower level of β-catenin nuclear translocation.  Our results suggest that BRBs inhibit colonic ulceration partly through inhibiting aberrant epigenetic events that dysregulate Wnt signaling.
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