• 제목/요약/키워드: Crohn`s disease

검색결과 165건 처리시간 0.023초

The Role of Autophagy in Eosinophilic Airway Inflammation

  • Jinju Lee;Hun Sik Kim
    • IMMUNE NETWORK
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    • 제19권1호
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    • pp.5.1-5.12
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    • 2019
  • Autophagy is a homeostatic mechanism that discards not only invading pathogens but also damaged organelles and denatured proteins via lysosomal degradation. Increasing evidence suggests a role for autophagy in inflammatory diseases, including infectious diseases, Crohn's disease, cystic fibrosis, and pulmonary hypertension. These studies suggest that modulating autophagy could be a novel therapeutic option for inflammatory diseases. Eosinophils are a major type of inflammatory cell that aggravates airway inflammatory diseases, particularly corticosteroid-resistant inflammation. The eosinophil count is a useful tool for assessing which patients may benefit from inhaled corticosteroid therapy. Recent studies demonstrate that autophagy plays a role in eosinophilic airway inflammatory diseases by promoting airway remodeling and loss of function. Genetic variant in the autophagy gene ATG5 is associated with asthma pathogenesis, and autophagy regulates apoptotic pathways in epithelial cells in individuals with chronic obstructive pulmonary disease. Moreover, autophagy dysfunction leads to severe inflammation, especially eosinophilic inflammation, in chronic rhinosinusitis. However, the mechanism underlying autophagy-mediated regulation of eosinophilic airway inflammation remains unclear. The aim of this review is to provide a general overview of the role of autophagy in eosinophilic airway inflammation. We also suggest that autophagy may be a new therapeutic target for airway inflammation, including that mediated by eosinophils.

위장관 출혈의 영상의학적 진단법 (Radiologic Diagnosis of Gastrointestinal Bleeding)

  • 김세형
    • 대한영상의학회지
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    • 제84권3호
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    • pp.520-535
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    • 2023
  • 위장관 출혈은 단일 질환이 아니라 광범위한 위장 질환의 증상 및 임상적 발현이다. 임상적 양상에 따라 명백한 출혈, 잠재 출혈, 원인 불명 출혈로 나눌 수 있으며, 출혈 위치에 따라 Treiz 인대를 기준으로 상부 또는 하부 위장관 출혈로 분류할 수 있다. 혈관 질환, 용종, 종양, 크론병, 이소성 췌장 및 이소성 위조직 등 다양한 질환이 위장관 출혈을 일으킬 수 있다. 명백한 출혈을 위한 영상 검사기법은 CT 혈관조영술, 고식적 혈관조영술 및 핵의학적 검사 등이 사용된다. 잠재 위장관 출혈을 평가하기 위한 영상검사로는 CT 소장조영술이 주로 사용되며, 위장관을 적절히 팽창해서 영상을 획득해야 위음성 혹은 위양성을 최소화하여 진단능을 높일 수 있다. CT 소장조영술에서 진단이 확실하지 않은 경우, Meckel scan이 보완적으로 사용될 수 있다. 원인 불명 위장관 출혈에 대한 검사는 임상 양상과 임상의 혹은 영상의학과 의사의 선호도에 따라 다양한 검사가 시행될 수 있으며, 이에 대한 추가적인 연구가 필요하다.

Inflammatory Bowel Disease and Risk of Cholangiocarcinoma: Evidence from a Meta-analysis of Population-based Studies

  • Huai, Jia-Ping;Ding, Jin;Ye, Xiao-Hua;Chen, Yan-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3477-3482
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    • 2014
  • Objective: Patients with inflammatory bowel disease (IBD) have an increased risk of extra-intestinal cancer, whereas its impact on cholangiocarcinoma (CC) remains unknown. The aim of this study was to obtain a reliable estimate of the risk of CC in IBD patients through a meta-analysis of clinical observational studies. Methods: Relevant studies were retrieved by searching PUBMED, EMBASE and Web of Science Databases up to Dec 2013. Four population-based case-control and two cohort studies with IBD were identified. Summary relative risk (RR) and its corresponding 95% confidence interval (CI) were calculated using a random-effects model. Potential sources of heterogeneity were detected using subgroup analyses. Results: The pooled risk estimate indicated IBD patients were at increased risk of CC (RR = 2.63, 95%CI = 1.47-4.72). Moreover, the increased risk of CC was also associated with Crohn's disease (RR = 2.69, 95%CI = 1.59-4.55) and ulcerative colitis (RR = 3.40, 95%CI = 2.50-4.62). In addition, site-specific analyses revealed that IBD patients had an increased risk of intrahepatic CC (ICC) (RR = 2.61, 95%CI = 1.72-3.95) and extrahepatic CC (ECC) (RR = 1.47, 95%CI = 1.10-1.97). Conclusions: This study suggests the risk of CC is significantly increased among IBD patients, especially in ICC cases. Further studies are warranted to enable definite conclusions to be drawn.

Epithelial-mesenchymal Transition and Its Role in the Pathogenesis of Colorectal Cancer

  • Zhu, Qing-Chao;Gao, Ren-Yuan;Wu, Wen;Qin, Huan-Long
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2689-2698
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    • 2013
  • Epithelial-to-mesenchymal transition (EMT) is a collection of events that allows the conversion of adherent epithelial cells, tightly bound to each other within an organized tissue, into independent fibroblastic cells possessing migratory properties and the ability to invade the extracellular matrix. EMT contributes to the complex architecture of the embryo by permitting the progression of embryogenesis from a simple single-cell layer epithelium to a complex three-dimensional organism composed of both epithelial and mesenchymal cells. However, in most tissues EMT is a developmentally restricted process and fully differentiated epithelia typically maintain their epithelial phenotype. Recently, elements of EMT, specially the loss of epithelial markers and the gain of mesenchymal markers, have been observed in pathological states, including epithelial cancers. Increasing evidence has confirmed its presence in human colon during colorectal carcinogenesis. In general, chronic inflammation is considered to be one of the causes of many human cancers including colorectal cancer(CRC). Accordingly, epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and Crohn's disease, the two major forms of inflammatory bowel disease, have an increased risk of developing CRC. A large body of evidence supports roles for the SMAD/STAT3 signaling pathway, the NF-kB pathway, the Ras-mitogenactivated protein kinase/Snail/Slug and microRNAs in the development of colorectal cancers via epithelial-tomesenchymal transition. Thus, EMT appears to be closely involved in the pathogenesis of colorectal cancer, and analysis refered to it can yield novel targets for therapy.

인간유방암 MDA-MB-231세포에서 peptide H에 의한 TNFα 발현 억제 (Peptide H reduces Il-6 expression in human breast cancer MDA-MB-231 cells)

  • 성대일;박잠언;강충경;김한복
    • 미생물학회지
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    • 제51권3호
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    • pp.308-311
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    • 2015
  • 청국장은 다양한 peptide류를 포함한다. 청국장 유래의 peptide H를 인간유방암 MDA-MB-231 세포에 처리했을 때, $TNF{\alpha}$ 발현은 뚜렷하게 억제되었다. $TNF{\alpha}$에 의해 유도되는 IL6 발현 역시, peptide H에 의해 감소될 수 있음을 시사해 준다. Peptide H구조는 glucocorticoid, dexamethasone과 전혀 유사하지 않아 그들과 다른 기작으로 $TNF{\alpha}$ 발현억제에 작용할 것을 시사해 준다. Peptide H는 $TNF{\alpha}$ 발현 억제 효과가 있으므로 보다 깊이 있는 연구를 바탕으로, 류마티스 관절염, 크론병 등의 치료제로 개발될 수 있기를 기대해 본다.

염증성 장질환 모델 및 크론병 환자에서의 점막상피 HuR 단백질의 변화 분석 (Tissue Distribution of HuR Protein in Crohn's Disease and IBD Experimental Model)

  • 최혜진;박재홍;박지연;김주일;박성환;오창규;도기헌;송보경;이승준;문유석
    • 생명과학회지
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    • 제24권12호
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    • pp.1339-1344
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    • 2014
  • 염증성 장질환은 점막의 만성적 궤양과 염증을 동반하는 면역질환으로 알려져 있으며, 특히 TNF${\alpha}$와 같은 염증성 사이토카인은 주요한 생물학적 치료의 표적으로 이용되고 있다. 염증성 사이토카인의 유전자발현에서 전사물의 안정화는 매우 중요한 조절과정이며, 특히 본 연구에서는 이 안정화에 핵심적인 단백질인 HuR의 발현과 조직 분포에 대하여 동물모델과 환자의 조직에서 분석하였다. DSS를 처리함으로 유도되는 장염증 동물 모델에서 HuR 단백질의 발현량이 높았음을 확인했고, 점막의 상피조직 및 선조직 상피세포에서 상대적인 발현이 증대되었다. 또한 단백질의 활성측면에서 세포질로 이동된 HuR 단백질의 양도 상대적으로 증가하였다. 공간분포적으로 보면 DSS에 의한 화학적 점막자극에 의하여 초기에는 villi 하부에서의 발현정도가 상대적으로 villus 말단에 비하여 높게 유지되었다. 크론병 환자의 생검을 통하여 정상부위와 병변부위에서 HuR 단백질을 비교분석 하였다. 크론병 환자들의 병변에서는 지속적으로 HuR의 발현이 증대되어 있음을 확인했으며, 동물조직과 유사하게 병변부위의 장관상피세포 및 선 상피에서 주로 발현양이 높았다. 이러한 결과는 염증성 장질환에서의 HuR 단백질이 초기 염증성 인자의 발현에 중요한 역할이 예상되며, 구체적인 분자기전의 규명도 향후 기대된다. 이를 근간으로 하여 염증성 장질환의 진단과 치료의 표적개발에서 유용하게 응용하고자 한다.

Pre-diagnostic Clinical Presentations and Medical History Prior to the Diagnosis of Inflammatory Bowel Disease in Children

  • Kwon, Yong Hoon;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권3호
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    • pp.178-184
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    • 2013
  • Purpose: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. Methods: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. Results: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. Conclusion: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.

Comparison of missing data methods in clustered survival data using Bayesian adaptive B-Spline estimation

  • Yoo, Hanna;Lee, Jae Won
    • Communications for Statistical Applications and Methods
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    • 제25권2호
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    • pp.159-172
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    • 2018
  • In many epidemiological studies, missing values in the outcome arise due to censoring. Such censoring is what makes survival analysis special and differentiated from other analytical methods. There are many methods that deal with censored data in survival analysis. However, few studies have dealt with missing covariates in survival data. Furthermore, studies dealing with missing covariates are rare when data are clustered. In this paper, we conducted a simulation study to compare results of several missing data methods when data had clustered multi-structured type with missing covariates. In this study, we modeled unknown baseline hazard and frailty with Bayesian B-Spline to obtain more smooth and accurate estimates. We also used prior information to achieve more accurate results. We assumed the missing mechanism as MAR. We compared the performance of five different missing data techniques and compared these results through simulation studies. We also presented results from a Multi-Center study of Korean IBD patients with Crohn's disease(Lee et al., Journal of the Korean Society of Coloproctology, 28, 188-194, 2012).

Preclinical Efficacy and Mechanisms of Mesenchymal Stem Cells in Animal Models of Autoimmune Diseases

  • Lee, Hong Kyung;Lim, Sang Hee;Chung, In Sung;Park, Yunsoo;Park, Mi Jeong;Kim, Ju Young;Kim, Yong Guk;Hong, Jin Tae;Kim, Youngsoo;Han, Sang-Bae
    • IMMUNE NETWORK
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    • 제14권2호
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    • pp.81-88
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    • 2014
  • Mesenchymal stem cells (MSCs) are present in diverse tissues and organs, including bone marrow, umbilical cord, adipose tissue, and placenta. MSCs can expand easily in vitro and have regenerative stem cell properties and potent immunoregulatory activity. They inhibit the functions of dendritic cells, B cells, and T cells, but enhance those of regulatory T cells by producing immunoregulatory molecules such as transforming growth factor-${\beta}$, hepatic growth factors, prostaglandin $E_2$, interleukin-10, indolamine 2,3-dioxygenase, nitric oxide, heme oxygenase-1, and human leukocyte antigen-G. These properties make MSCs promising therapeutic candidates for the treatment of autoimmune diseases. Here, we review the preclinical studies of MSCs in animal models for systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, and experimental autoimmune encephalomyelitis, and summarize the underlying immunoregulatory mechanisms.

Anti Inflammatory Effect of Low Level Laser Irradiation on the LPS-stimulated Murine Immunocytes

  • Jin, Dan;Lee, Jong-Young;Cho, Hyun-Chul;Kim, Soo-Ki
    • Molecular & Cellular Toxicology
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    • 제1권2호
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    • pp.124-129
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    • 2005
  • Pro-inflammatory cytokines, such as tumor necrosis factor $(TNF)-{\alpha}$, interleukin-12 (IL-12) and interleukin $(IL-1)-{\beta}$, play a key role in causing inflammatory diseases, which are rheumatoid arthritis, Crohn's disease and sepsis. Accumulating evidences suggest that low level laser irradiation (LLLI) may have an anti-inflammatory action. However, there are few data regarding down regulation of Th1 immune response by using the diod typed laser emitting device for human patients. As a fundamental step in order to address this issue, we investigated immunological impact of the low level laser irradiation (10 mw laser diode with a wavelength of 630 nm) on expression of pro-inflammatory cytokines in murine immunocytes (splenocytes and peritoneal macrophages) in vitro. The LLLI on lipopolysaccharide (LPS 100 ng/ml)-stimulated murine splenocytes and macrophages, clearly down regulated mRNA expression of $TNF-{\alpha}$ and IL-12 in dose-dependent manner. In addition, LLLI significantly inhibits the NO production in the LPS-stimulated murine macrophages. This data suggests that LLLI (wavelength of 630 nm) may exert an anti-inflammatory action via modulation of pro-inflammatory cytokine and NO production pathway.