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Disease Behaviour (disease + behaviour)

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Medical Sciences	100%

Selected Abstracts

Combined type-1 plasminogen activator inhibitor and NOD2/CARD15 genotyping predicts complicated Crohn's disease behaviour

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007
M. ALVAREZ-LOBOS
Summary Background NOD2/CARD15 gene variants have not been universally associated with stricturing behaviour in Crohn's disease. Other behaviour modifying genes could explain these results. Aim To study the combined influence of NOD2/CARD15 variants and 4G/4G genotype of type-1 plasminogen activator inhibitor (PAI-1) gene on Crohn's disease behaviour. Methods One hundred and seventy Crohn's disease patients were studied prospectively, with a mean follow-up of 7± 6 years. Disease behaviour was registered by using two criteria: the Vienna classification and a non-hierarchical classification based on the behavioural Vienna categories. Results In the multivariate analysis for stricturing behaviour according to the Vienna categories, only absence of colonic disease (OR, 4.0; 95% CI: 1.49,11.1; P = 0.006) was an independent predictive factor. However, in the multivariate analysis for stricturing disease applying a non-hierarchical criteria, ileal disease (OR, 4.19; 95% CI: 1.30,13.5; P = 0.01), and carrying both NOD2/CARD15 variants and the 4G/4G PAI-1 genotype (OR, 5.02; 95% CI: 1.44,17.48; P = 0.01) were independent predictive factors. In the multivariate analysis for penetrating behaviour, the 4G/4G PAI-1 (OR, 3.10; 95% CI: 1.54,6.23; P = 0.001) and male sex (OR, 2.44; 95% CI: 1.30,4.60; P = 0.005) were independent predictive factors irrespective of criteria applied. Conclusions Combined PAI-1 and NOD2/CARD15 genotyping predict complicated Crohn's disease. Patients with these variants could benefit from early interventions. [source]

Tenascin-C in primary malignant melanoma of the skin

HISTOPATHOLOGY, Issue 4 2004
S Ilmonen
Aims :,To investigate the expression and the prognostic role of glycoprotein Tenascin-C (Tn-C) in primary melanoma of the skin. Methods and results :,The immunohistochemical expression of Tn-C was studied in 98 primary melanomas and related to inflammation, invasion, and patient outcome. Patients were followed up for disease recurrence for 0.04,7.4 years (median 3.9) and for survival for 0.5 to 12.1 years (median 9.3). The expression of Tn-C was evaluated for each tumour invasion border; the stromal and intracytoplasmic Tn-C of the melanoma islets were also recorded. Tn-C is widely expressed in primary melanoma samples, the staining pattern varying from focal to diffuse in different parts of the tumour. No correlation existed between intensity of Tn-C staining and inflammation. No stromal Tn-C was detected at the upper dermal lateral border in 12 patients, nor at the deep, dermal or subcutaneous border in 14 patients. These patients showed better disease-free survival (DFS) than did those cases with focal or diffuse staining (P = 0.06, P = 0.05). Also, absence of intracytoplasmic Tn-C was a beneficial prognostic factor for DFS (P = 0.04). In multivariate analysis, tumour ulceration and intracytoplasmic Tn-C expression of melanoma cells were independent adverse prognostic factors for DFS. Conclusions :,In primary melanoma of the skin, absence of Tn-C in the stroma of invasion fronts and within tumour cells seems to be related to a more benign disease behaviour with a lower risk of developing metastases. [source]

Interleukin 10 (IL-10) gene variants and susceptibility for paediatric onset Crohn's disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009
D. K. AMRE
Summary Background, A recent genome-wide association study in adult patients with ulcerative colitis (UC) has implicated the interleukin 10 (IL-10) gene as an important candidate gene. Moreover, a UC-associated single nucleotide polymorphism (SNP) rs3024405 was also significantly associated with adult Crohn's disease (CD). Aims, To examine whether IL-10 -CD associations extended to paediatric-onset CD. Methods, We implemented the case-control design at three paediatric gastroenterology clinics in Canada. CD patients (,20 years) were recruited along with healthy controls. DNA samples were genotyped for tag-single nucleotide polymorphisms (tag-SNPs) in the IL-10 gene. Allelic, genotype and haplotype associations with CD were studied. Results, A total of 270 patients and 336 controls were studied. The mean age (±s.d.) at diagnosis was 12.1 (±3.5). There were a slightly higher proportion of male patients (56.3%). Of the five IL-10 tag-SNPs, rs2222202 (C/T) (P = 0.03) and rs1800871 (C/T) (P = 0.05) showed significant allelic associations with CD. Specific IL-10 SNPs were associated with CD disease location and/or disease behaviour. Conclusions, Our gene-wide analysis replicates recent findings of associations between IL-10 and adult CD, and suggests that these associations extend to paediatric-onset CD as well. [source]

Review article: reproduction in the patient with inflammatory bowel disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007
Z. S. HEETUN
Summary Background, Inflammatory bowel disease (IBD) affects mainly the young population. The effect of IBD and its treatment on fertility and pregnancy is therefore an important clinical consideration. Aim, To review the best management of IBD in the reproductive and pregnant population. Methods, A MEDLINE and an EMBASE search were performed using mainly the search phrases ,pregnancy AND IBD,',sulphasalazine AND male fertility,',abdominal surgery AND female fertility,',AZA AND placenta' and ,infliximab AND pregnancy.' No language or date restrictions were placed. References of review articles were examined. Results, Overall male and female fertility are not affected by IBD. Sulphasalzine reduces male fertility. No other drugs used in IBD affect significantly fertility in humans. The risk of pregnancy-related complications and the disease behaviour during pregnancy depends mainly on disease activity at time of conception. Proactive treatment for maintenance of disease remission during gestation is recommended. Except for methotrexate, drugs used in IBD appear safe in pregnancy. Breast feeding should be encouraged. Conclusion, The management of IBD in the young and pregnant population remains controversial because the literature comes mostly from retrospective studies. Further studies particularly large prospective trials are needed to guide clinicians in decision making. [source]

Combined type-1 plasminogen activator inhibitor and NOD2/CARD15 genotyping predicts complicated Crohn's disease behaviour

Bullous pemphigoid in pregnancy: contrasting behaviour in two patients

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2001
B.C. Gee
Bullous pemphigoid (BP) is an increasingly common immunobullous disease of the elderly, and, due to the late age of onset, is rarely seen in women of fertile age. Consequently, to the best of our knowledge no cases of BP in pregnancy have been described. We present two cases of BP that have differed in disease behaviour during pregnancy. [source]

Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients

BRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2003
Nilima Parry-Jones
Summary. Splenic lymphoma with villous lymphocytes (SLVL) is a low-grade B-cell lymphoma defined in the World Health Organization classification as the leukaemic form of splenic marginal zone lymphoma. Presenting features and response to therapy have been described, but information on prognostic factors is scanty. Clinical, laboratory and follow-up data were collected on 129 patients with SLVL to determine features predicting disease behaviour and survival. Diagnosis was made on clinical, morphological and immunophenotypic features and, where available, bone marrow and spleen histology. Median age was 69 years (range 39,90 years) and male:female ratio, 0·9. The majority had splenomegaly, but lymphadenopathy and hepatomegaly were rare. Median Hb was 11·8 g/dl, white blood cell count was 16 × 109/l and platelet count was 145 × 109/l; 27% of patients had monoclonal protein in serum and/or urine. While 27% of patients remained untreated, 10% transformed to high-grade lymphoma. Median follow-up was 61 months and median survival was 13 years, with 72% of patients alive at 5 years. Cox regression analysis showed that increasing age, anaemia, thrombocytopenia and lymphocytosis >,16 × 109/l were independent adverse predictors of overall survival. However, only anaemia and lymphocytosis >,16 × 109/l remained highly significant independent prognostic factors when only deaths due to lymphoma were analysed. Splenectomized patients fared better than those receiving chemotherapy only (P = 0·001 for SLVL deaths). We conclude that SLVL is mainly a disease of the elderly with a relatively benign course but, when treatment is required, splenectomy is beneficial. [source]

Meta-analysis: polymorphisms in TNF-, gene promoter and Crohn's disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
Z. Han
Aliment Pharmacol Ther 2010; 32: 159,170 Summary Background, Tumour necrosis factor alpha (TNF-,) is involved in the pathogenesis of Crohn's disease (CD). However, results on the association between the polymorphisms in TNF-, promoter and the risk of CD are inconsistent. Aim, To perform a quantitative synthesis for the genetic polymorphisms in TNF-, promoter and CD risk. Methods, Databases were searched (up to 2009) and 31 studies were included. Risks of CD associated with the polymorphisms in TNF-, promoter were assessed. Results, Overall, individuals with -1031 TC+CC genotype had a slightly increased risk to develop CD compared with individuals with -1031 TT genotype (OR, 1.32; 95% CI, 1.03,1.70). In the further stratified analysis, we found Asians with the -1031T>C, -863 C>A and -857 C>T variant polymorphisms have almost one and a half CD risk compared with other genotypes (OR, 1.58; 95% CI, 1.16,2.15; OR, 1.55; 95% CI, 1.18,2.02; OR, 1.54; 95% CI, 1.19,1.99 respectively). We did not find -308 G>A variant associated with CD location and disease behaviours in stratified analysis. Conclusions,TNF-, polymorphisms in the promoter region might be used as a biomarker for CD risk prediction. Larger studies with mixed ethnicity subjects and stratified by clinical and sub clinical characteristics are needed to validate our findings. [source]