Clinicopathologic features and outcome of mycophenolate-induced colitis in renal transplant recipients

Reports on the clinical course of mycophenolic acid (MPA)-related colitis in kidney transplant recipients are scarce. This study aimed at assessing MPA-related colitis incidence, risk factors, and progression after kidney transplantation. All kidney transplant patients taking MPA who had colonic biopsies for persistent chronic diarrhea, between 2000 and 2012, at the Kidney Transplantation Unit of Botucatu Medical School Hospital, Brazil, were included. Cytomegalovirus (CMV) immunohistochemistry was performed in all biopsy specimens. Data on presenting symptoms, medications, immunosuppressive drugs, colonoscopic findings, and follow-up were obtained. Of 580 kidney transplant patients on MPA, 34 underwent colonoscopy. Colonoscopic findings were associated with MPA usage in 16 patients. The most frequent histologic patterns were non-specific colitis (31.3%), inflammatory bowel disease (IBD)-like colitis (25%), normal/near normal (18.8%), graft-versus-host disease-like (18.8%), and ischemia-like colitis (12.5%). All patients had persistent acute diarrhea and weight loss. Six of the 16 MPA-related diarrhea patients (37.5%) showed acute dehydration requiring hospitalization. Diarrhea resolved when MPA was switched to sirolimus (50%), discontinued (18.75%), switched to azathioprine (12.5%), or reduced by 50% (18.75%). No graft loss occurred. Four patients died during the study period. Late-onset MPA was more frequent, and no correlation with MPA dose or formulation was found.

Avaliação da influência do estresse em modelo experimental de colite por administração de Ácido Trinitrobenzenosulfônico (TNBS) em concentração subinflamatória

Inflammatory bowel disease (IBD) is a chronic and relapsing disease caused by exaggerated response of the immune system. It represents a significant health problem by limiting the quality of life and being the main risk factor for colorectal cancer. Despite of its importance, the high worldwide incidence and being the object of research for several decades, the etiology remains unknown. Studies indicates an interaction between genetic and environmental factors which together with the intestinal microbiota, leads to an uncontrolled immune response. One of the aggravating environmental factors often discussed is stress, as the daily life of the population in general is increasingly rushed. In order to demonstrate the influence of stress on IBD, this study aimed to standardize an experimental model of colitis induced by instillation of a trinitrobenzene sulfonic acid (TNBS) noninflammatory concentration plus exposure to stress that intensify the inflammation. Therefore, an experiment was done to determine what would be the noninflammatory concentration. In this step, four different concentrations of TNBS (1, 6, 12.5 or 40mg/ml) were tested and the lowest concentration capable of inducing a noninflammatory response in the gut was defined as 1 mg/ml. Then, a second experiment was performed which induced colitis and exposed the animals to restraint stress. The results, however, showed that this stimulus was not enough to exacerbate the damage caused by the 1 mg/ml concentration of TNBS in the colon. With some changes in the protocol, the third experiment associated cold and restraint, as well as changes on the day of euthanasia, which occurred immediately after the stress session. The results of myeloperoxidase activity measurement were unexpected due to the noninflammatory concentration of TNBS caused an intestinal inflammation similar to the concentration of 40 mg/ml. However, the results of glutathione quantification and the corticosterone ...

Colangiohepatite Felina

Cholangiohepatitis is a common hepatic disorder in cats that is second only to hepatic lipidosis in frequency. The cholangitis-cholangiohepatitis complex is known as the diseases that involve the biliar tract inflammation and may extend to the liver. The classification of the cholangiohepatitis is still controversial, in this present study the following classification was used: Acute Cholangiohepatitis, Chronic Cholangiohepatitis, Lymphocitic Cholangitis. The cholangiohepatitis may be associated with pancreatitis and inflammatory bowel disease, this association is known as feline triaditis. The diagnosis is based on the clinical signs, alterations in laboratory exams and ultrasonography alterations, but the definitive diagnosis is only possible through liver biopsy. The treatment for each type of cholangiohepatitis differs, hence the importance of the right diagnosis. This study aimed to do a review over the ethiology, clinical presentation, diagnosis and treatment for this disease

Análise multielementar pela técnica de fluorescência de raios-X de amostras de cólon de roedores com colite e tratados com prednisolona

Pós-graduação em Biologia Geral e Aplicada - IBB

Bidens pilosa L: efeitos protetores na inflamação intestinal

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da dieta enriquecida com frutos das palmeiras Euterpe oleracea Mart. e Mauritia flexuosa L.f. na inflamação intestinal em ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Qualidade de vida relacionada à saúde em pacientes acometidos por doença inflamatória intestinal tratados com terapia biológica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Zeyheria montana Mart. (Bignoniaceae) as source of antioxidant and immunomodulatory compounds with beneficial effects on intestinal inflammation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Anti-inflammatory effects of Brazilian ginseng (Pfaffia paniculata) on TNBS-induced intestinal inflammation: experimental evidence

Inflammatory bowel disease (IBD) is a chronic, relapsing, idiopathic inflammation of the gastrointestinal tract. Clinical studies suggest that the initiation of IBD is multifactorial, involving genetics, the immune system and environmental factors, such as diet, drugs and stress. Pfaffia paniculata is an adaptogenic medicinal plant used in Brazilian folk medicine as an anti-stress agent. Thus, we hypothesised that the P. paniculata enhances the response of animals subjected to colonic inflammation. Our aim was to investigate the intestinal anti-inflammatory activity of P. paniculata in rats before or after induction of intestinal inflammation using trinitrobenzenesulfonic acid (TNBS). The animals were divided into groups that received the vehicle, prednisolone or P. paniculata extract daily starting 14days before or 7days after TNBS induction. At the end of the procedure, the animals were killed and their colons were assessed for the macroscopic damage score (MDS), extent of the lesion (EL) and weight/length ratio, myeloperoxidase (MPO) activity and glutathione (GSH), cytokines and C-reactive protein (CRP) levels. Histological evaluation and ultrastructural analysis of the colonic samples were performed. Treatment with the 200mg/kg dose on the curative schedule was able to reduce the MDS and the EL. In addition, MPO activity was reduced, GSH levels were maintained, and the levels of pro-inflammatory cytokines and CRP were decreased. In conclusion, the protective effect of P. paniculata was related to reduced oxidative stress and CRP colonic levels, and due to immunomodulatory activity as evidenced by reduced levels of IL-1β, INF-γ, TNF-α and IL-6.

Experimental evidence of MAP kinase gene expression on the response of intestinal anti-inflammatory drugs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Experimental evidence of heparanase, Hsp70 and NF-κB gene expression on the response of anti-inflammatory drugs in TNBS-induced colonic inflammation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associação entre concentração sérica de vitamina D e alterações da massa muscular esquelética em pacientes com doenças inflamatórias intestinais

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento de nano e micropartículas de quitosana encapsulando 4-metilesculetina e avaliação no tratamento da doença inflamatória intestinal

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Qualidade de vida e capacidade funcional em pacientes com doenças inflamatórias intestinais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Diagnóstico diferencial entre Doença de Crohn e Hidradenite Supurativa: relato de caso

Crohn’s disease is a chronic infl ammatory bowel disease with segmental transmural infl ammation, which complicate with formation of fi stulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is diffi cult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn’s disease complicated with perianal and rectovaginal fi stula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofl oxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fi stula at the site of resection, consistent with Crohn’s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fi stulas. Currently in therapy with good biological evolution of fi stulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn’s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient’s quality of life.