• Title/Summary/Keyword: crohn's disease

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A Pediatric Case of Inflammatory Bowel Disease with Renal Amyloidosis

  • Hyun, Hyesun;Park, Eujin;Kim, Ji Hyun;Cho, Myung Hyun;Kang, Hee Gyung;Moon, Jin Soo;Moon, Kyung Chul;Ha, Il-Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.81-85
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    • 2018
  • Amyloidosis is a rare disease that results from the deposition of extracellular protein in various body tissues, causing progressive organ dysfunction. Secondary renal amyloidosis is a rare but serious complication of chronic inflammatory bowel disease, particularly in patients with Crohn's disease or ulcerative colitis. We report a case of secondary renal amyloidosis in a pediatric patient who reported a 16-year history of "very early onset inflammatory bowel disease". Intensive treatment including repeated infliximab infusions improved clinical parameters of inflammatory bowel disease, although renal dysfunction showed progression. Amyloidosis should be considered in patients with IBD, particularly if they suffered disease progression.

Establishment and Characterization of Patient-Derived Intestinal Organoids from Pediatric Crohn's Disease Patients

  • Sunghyun An;Homin Huh;Jae Sung Ko;Jin Soo Moon;Ky Young Cho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.6
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    • pp.355-363
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    • 2024
  • Purpose: This study aimed to establish and characterize patient-derived intestinal organoids (PDOs) from children with Crohn's disease (CD). Methods: To generate PDOs, endoscopic biopsy specimens were obtained from non-inflamed duodenal bulbs of normal controls and CD patients. To verify the presence of PDOs, histological staining and quantitative reverse transcription polymerase chain reaction (RT-qPCR) analyses were performed. Results: PDOs were successfully established in normal controls (n=2) and CD patients (n=2). Hematoxylin and eosin staining of formalin-fixed, paraffin-embedded PDO sections revealed crypt and villus structures, whereas immunofluorescence staining with EpCAM and DAPI confirmed the epithelial-specific architecture of the PDOs. RT-qPCR results revealed a significant increase in Lgr5, Si, and Chga gene expression and a decrease in Olfm4 and Muc2 expression in CD patients compared to normal controls, suggesting altered stem cell activity and mucosal barrier function (p<0.05). Conclusion: We successfully established and characterized PDOs in children with CD, providing a valuable tool for understanding the pathophysiology of the disease and evaluating potential therapeutic approaches. The differential gene expression of PDOs in CD patients might be caused by the complex interplay between epithelial adaptation and inflammation in the intestinal epithelium.

Effects of Moxi-tar Herbal Acupuncture at Cheonchu (ST25) on Crohn's Disease Induced by TNBS in Mices (천추(天樞) 상응부위에 구진약침(灸津藥針) 자극(刺戟)이 TNBS로 유도(誘導)된 크론병에 미치는 영향)

  • Kim, Yong-Tae;Ahn, Seong-Hun;Kim, Jae-Hyo;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.25 no.2
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    • pp.159-177
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    • 2008
  • Objectives : Crohn's disease is a severe chronic inflammation that is treated mainly by immunosuppression, which often has serious side effects. There is need to develop new therapeutic methods or drugs that have few side effects in order to treat this disease. Acupuncture with Moxi-tar at Cheonchu (ST25) has anti-inflammatory properties, but the mechanism of its anti-inflammatory actions is unclear. We investigated the protective effects and speculated the mechanisms of acupuncture with Moxi-tar at ST25 on trinitrobenzene sulfonic acid (TNBS) induced colitis in mice which is a well known Crohn's disease animal model. Methods : 5 % TNBS was treated at day 1 and day 7 into rectum of mice. To investigate therapeutic effects of acupuncture with Moxi-tar at ST25, acupuncture was carried out on day 3, and day 6. For the data analysis, we observed macroscopic and microscopic findings of the colon. Weight and width of the colon, degree of damage, changes of body weight, and myeloperoxygenase (MPO) activity were checked. For analysing protein expression, we carried out immunohistochemical staining and Western blot. For analysing mRNA expression, RT-PCR was carried out. Results : TNBS induced damages on the colon of mice, while acupuncture of Moxi-tar at ST25 suppressed TNBS mediated damages similar to those on the colons of mice in the control (not treated with TNBS) group. The average body weight of TNBS treated mice (77.4%) was decreased compared with that of the control mice (105%), and acupuncture with Moxi-tar at ST25 suppressed the loss of body weight caused by TNBS (from 77.4% to 95.3%). TNBS induced infiltration of immune cells in all layers of the colon while acupuncture with Moxi-tar at ST25 suppressed infiltration of immune cells caused by TNBS. Furthermore, acupunctured with Moxi-tar at ST25 suppressed macro-, micro- colonic damages caused by TNBS. Acupunctured with Moxi-tar at ST25 dramatically improved the clinical and histopathological symptoms such as the increase in weight of the distal colon and the MPO activity in TNBS-induced colitis. Acupuncture with Moxi-tar at ST25 down-regulated the nuclear transcription factor kappa B ($NF-{\kappa}B$) activity and suppressed tumor necrosis factor-a (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-1${\beta}$), and intracellular adhesion molecule-1 (ICAM-1) expressions caused by TNBS. Conclusions : Acupuncture with Moxi-tar at ST25 helps recovery from the TNBS-induced colonic damage by down-regulation of $NF-{\kappa}B$ activity and suppressing of TNF-${\alpha}$, IL-1${\beta}$, and ICAM-1 expressions. This may be an important method for the treatment of Crohn's disease.

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Use of Anti-TNF Alpha Blockers Can Reduce Operation Rate and Lead to Growth Gain in Pediatric Crohn's Disease

  • Woo, Min Hyung;Cho, Young Hoon;Sohn, Min Ji;Lee, Eun Joo;Kim, Ju Whi;Moon, Jin Soo;Ko, Jae Sung;Kim, Hyun-young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.4
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    • pp.358-368
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    • 2019
  • Purpose: Pediatric Crohn's disease (CD) is directly related to growth and has a high probability of requiring surgical intervention(s); therefore, more active treatment for CD is required for children. This study investigated the impact of biologics on growth and disease course associated with surgery. Methods: This was a retrospective cohort study involving patients diagnosed with CD at the Seoul National University Children's Hospital (Seoul, Korea) between January 2006 and October 2017. The aim was to determine the characteristics of pediatric patients with CD and whether biologics affected growth and the surgical disease course. Results: Among patients who underwent surgery for CD, the mean number of operations per patient was 1.89. The mean time from initial diagnosis to surgery was 19.3 months. The most common procedure was fistulectomy (34%), followed by incision and drainage (25%). In all patients, the use of biologics increased the height (p=0.002) and body mass index (BMI) (p=0.005). Among patients who underwent surgery, height (p=0.004) and BMI (p=0.048) were increased in the group using biologics. Patients who used biologics exhibited a low operation rate only within 2 years after diagnosis, with no differences thereafter (p=0.027). Conclusion: Although biologics could not mitigate the operation rate in pediatric patients who underwent surgery for CD, biological therapy delayed disease progression within 2 years of disease onset. Additionally, biologics conferred growth and BMI benefits in this window period. Therefore, it may be helpful to use biologics for optimal growth in pediatric patients with a high probability of undergoing future surgery.

Remissions of Crohn's Disease at Onset and Relapse Using Herbal Medicine: A Case Report (발병과 재발에 한약으로 관해가 유도된 크론병 증례 보고)

  • Lee, Byung-Hee;Won, Jiyoon;Park, Jae Rang;Lee, Hyangsook
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.183-190
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    • 2020
  • This case report details two remissions at onset and relapse after 4 years each with Korean herbal medicine treatment in a 33-year-old male patient diagnosed as Crohn's disease (CD) by clinical and colonoscopic examination. He presented bloody diarrhea and severe abdominal pain, and his symptoms were persistent even with usual Western medications, so he was offered surgery and biologics. He was then given Sayeok-Tang for 8 months and remission was induced. Four years later he had a relapse and this time he was given Banha-Sasim-Tang, and Baekduong-Ga-Gamcho-Agyo-Tang, based on pattern changes with intense symptom monitoring. Clinical and endoscopic remission was confirmed after 4 months of herbal medicine treatment and no adverse events were reported. This case report shows that individualized Korean herbal medicine treatment has the potential for induction of remission of CD and further research is warranted.

Function and dysfunction of leucine-rich repeat kinase 2 (LRRK2): Parkinson's disease and beyond

  • Bae, Jae Ryul;Lee, Byoung Dae
    • BMB Reports
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    • v.48 no.5
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    • pp.243-248
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    • 2015
  • Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common cause of familial Parkinson's disease (PD). As such, functions and dysfunctions of LRRK2 in PD have been the subject of extensive investigation. In addition to PD, increasing evidence is suggesting that LRRK2 is associated with a wide range of diseases. Genome-wide association studies have implicated LRRK2 in Crohn's disease (CD) and leprosy, and the carriers with pathogenic mutations of LRRK2 show increased risk to develop particular types of cancer. LRRK2 mutations are rarely found in Alzheimer's disease (AD), but LRRK2 might play a part in tauopathies. The association of LRRK2 with the pathogenesis of apparently unrelated diseases remains enigmatic, but it might be related to the yet unknown diverse functions of LRRK2. Here, we reviewed current knowledge on the link between LRRK2 and several diseases, including PD, AD, CD, leprosy, and cancer, and discussed the possibility of targeting LRRK2 in such diseases. [BMB Reports 2015; 48(5): 243-248]

Clinical Remission of Crohn's Disease Induced by Herbal Decoction (Jinmoo-tang): A Case Report (진무탕으로 임상적 관해가 유도된 크론병 환자: 증례보고)

  • Lee, Byunghee;Won, Jiyoon;Lee, Hyangsook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.6
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    • pp.255-260
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    • 2021
  • Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD) with unknown etiopathogenesis. Currently there are no definitive treatment modalities for CD. This case report presents clinical remission and its maintenance of CD induced by Korean herbal medicine treatment. A 56-year-old male patient diagnosed as CD by capsule endoscopy presented to a Korean Medicine clinic with severe abdominal pain as a chief complaint. Despite taking 5-aminosalicylic acid and immunosuppressant for 2 years, his abdominal pain was worsening at the time of visit. Treatment was initiated with Jinmoo-tang based on pattern identification and continued for approximately a year with some modifications according to patient's symptom changes. He was mainly given Jinmoo-Tang for a year and clinical remission was achieved; he could stop taking western medications. For 6 years since then, he took Korean medicine from time to time when he felt his condition went down and he is still maintaining remission. There were no adverse events reported. This case report suggests that individualized Korean herbal medicine treatment may have the potential for induction and maintenance of clinical remission of CD. Further research is warranted to establish an evidence-base for such approach.

Panax ginseng: a candidate herbal medicine for autoimmune disease

  • Lee, Joon-Il;Park, Kyoung Sun;Cho, Ik-Hyun
    • Journal of Ginseng Research
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    • v.43 no.3
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    • pp.342-348
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    • 2019
  • Panax ginseng Meyer (P. ginseng; Korean ginseng) is well known for its medicinal properties. It can alleviate pathological symptoms, promote health, and prevent potential diseases via its anti-inflammatory, antioxidant, homeostatic, and other positive effects on biological metabolism. Although many studies have determined effects of P. ginseng on various diseases, such as cardiovascular, neurological, and immunological diseases, little is known about the effect of P. ginseng on autoimmune diseases. Here, we review a few reports about effects of P. ginseng on autoimmune diseases (e.g., multiple sclerosis, Crohn's disease, ulcerative colitis, atopic dermatitis, and rheumatoid arthritis) and suggest the possibility of P. ginseng as a candidate herbal medicine to prevent and treat autoimmune diseases as well as the need to study it.

Association study between OCTN1 functional haplotypes and Crohn's disease in a Korean population

  • Jung, Eun Suk;Park, Hyo Jin;Kong, Kyoung Ae;Choi, Ji Ha;Cheon, Jae Hee
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.1
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    • pp.11-17
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    • 2017
  • Crohn's disease (CD) is a chronic inflammatory bowel disease with multifactorial causes including environmental and genetic factors. Several studies have demonstrated that the organic cation/carnitine transporter 1 (OCTN1) non-synonymous variant L503F is associated with susceptibility to CD. However, it was reported that L503F is absent in Asian populations. Previously, we identified and functionally characterized genetic variants of the OCTN1 promoter region in Koreans. In that study, four variants demonstrated significant changes in promoter activity. In the present study, we determined whether four functional variants of the OCTN1 promoter play a role in the susceptibility to or clinical course of CD in Koreans. To examine it, the frequencies of the four variants of the OCTN1 promoter were determined by genotyping using DNA samples from 194 patients with CD and 287 healthy controls. Then, associations between genetic variants and the susceptibility to CD or clinical course of CD were evaluated. We found that susceptibility to CD was not associated with OCTN1 functional promoter variants or haplotypes showing altered promoter activities in in vitro assays. However, OCTN1 functional promoter haplotypes showing decreased promoter activities were significantly associated with a penetrating behavior in CD patients (HR=2.428, p=0.009). Our results suggest that the OCTN1 functional promoter haplotypes can influence the CD phenotype, although these might not be associated with susceptibility to this disease.