• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권1호
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• pp.7-18
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• 2021

Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.

• 한국식품영양학회지
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• 제36권3호
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• pp.172-184
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• 2023

The objective of this study was to determine the efficacy of a natural product of cherry tree (Prunus serrulata var. spontanea: PS) as a test substance for improving cytokine and ovalbumin-specific IgE using an ovalbumin-induced asthma disease model of 5-week-old male BALB/c mice. Lung tissue pathology was analyzed to confirm anti-inflammatory and asthmatic effects. As a result of examining the effect on changes in inflammatory cells in bronchoalveolar lavage fluid in an ovalbumin-induced asthma disease model by administering the PS sample, total cells, eosinophil, neutrophil, lymphocyte, and monocytes were significantly decreased. Concentrations of cytokine-based TNF-alpha and IL-4 and immunoglobulin E in serum were significantly increased in the asthma-inducing negative control group than in the normal group. However, high concentrations of PS decreased them. In histopathological examination of the lung tissue, it was confirmed that inflammatory cells infiltrated around the alveoli and bronchioles were increased in ovalbumin-induced asthma disease model. After administration of cherry tree extract, bronchiolar morphological changes such as mucosal thickening were slightly improved. From the above results, it was confirmed that extract of cherry tree significantly reduced inflammation expression and tissue damage in alveolar tissues. It was also confirmed that the cherry tree extract had an excellent efficacy in improving asthma inflammation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.67-71
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• 2008

최근들어 우리나라에서 소아 염증성 장질환 특히 크론병의 유병률이 매우 빠르게 증가하고 있다. 염증성 장질환의 진단을 위해 자세한 병력 청취와 혈액 검사 그리고 대장 내시경 검사가 필요하다. 대부분의 환자에서 복통, 설사, 체중감소, 혈변 등의 전형적인 증상을 보이지만 비전형적인 발현으로 장기간 진단에 어려움을 겪을 수 있어 주의를 요한다.

• Clinical and Experimental Pediatrics
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• 제57권11호
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• pp.465-471
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• 2014

Inflammatory bowel disease (IBD) is a chronic relapsing disorder of unknown etiology, which is believed to be multifactorial. Recently, the incidence of pediatric IBD has steeply increased in Korea since 2000. Poorly controlled disease activity can result in complications such as intestinal fistulae, abscess, and stricture, as well as growth retardation and delayed puberty in children. Because of a lack of confirmative tests, various diagnostic modalities must be used to diagnose IBD. Onset age, location, behavior, and activity are important in selecting treatments. Monogenic IBD must be excluded among infantile and refractory very-early-onset IBD. Early aggressive therapy using biologics has recently been proposed for peripubertal children to prevent growth failure and malnutrition.

• Biomolecules & Therapeutics
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• 제28권3호
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• pp.222-229
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• 2020

The process of drug discovery and drug development consumes billions of dollars to bring a new drug to the market. Drug development is time consuming and sometimes, the failure rates are high. Thus, the pharmaceutical industry is looking for a better option for new drug discovery. Drug repositioning is a good alternative technology that has demonstrated many advantages over de novo drug development, the most important one being shorter drug development timelines. In the last two decades, drug repositioning has made tremendous impact on drug development technologies. In this review, we focus on the recent advances in drug repositioning technologies and discuss the repositioned drugs used for inflammatory diseases such as sepsis, asthma, and atopic dermatitis.

• Clinical Endoscopy
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• 제55권6호
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• pp.726-735
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• 2022

Inflammatory bowel disease (IBD) has a global presence with rapidly increasing incidence and prevalence. Patients with IBD including those with ulcerative colitis and Crohn's disease have a higher risk of developing colorectal cancer (CRC) compared to the general population. Risk factors for CRC in patients with IBD include long disease duration, extensive colitis, primary sclerosing cholangitis, family history of CRC, stricture, and prior dysplasia. Surveillance colonoscopy for CRC in patients with IBD should be tailored to individualized risk factors and requires careful monitoring every year to every five years. The current surveillance techniques are based on several guidelines. Chromoendoscopy with targeted biopsy is being recommended increasingly, and high-definition colonoscopy is gradually replacing standard-definition colonoscopy. However, it remains unclear whether chromoendoscopy, virtual chromoendoscopy, or white-light endoscopy has better efficiency when a high-definition scope is used. With the development of new endoscopic instruments and techniques, the paradigm of surveillance strategy has gradually changed. In this review, we discuss cutting-edge surveillance colonoscopy in patients with IBD including a review of literature.

• Clinical Endoscopy
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• 제55권4호
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• pp.480-488
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• 2022

Endoscopy is vital for diagnosis, assessing treatment response, monitoring and surveillance in patients with inflammatory bowel disease (IBD). With the growing importance of mucosal healing as a treatment target, the assessment of disease activity by endoscopy has been accepted as the standard of care for IBD. There are many endoscopic activity indices for facilitating standardized reporting of the gastrointestinal mucosal appearance in IBD, and each index has its strengths and weaknesses. Although most endoscopic indices do not have a clear-cut validated definition, endoscopic remission or mucosal healing is associated with favorable outcomes, such as a decreased risk of relapse. Therefore, experts suggest utilizing endoscopic indices for monitoring disease activity and optimizing treatment to achieve remission. However, the regular monitoring of endoscopic activity is limited in practice owing to several factors, such as the complexity of the procedure, time consumption, inter-observer variability, and lack of a clear-cut, validated definition of endoscopic response or remission. Although experts have recently suggested consensus-based definitions, further studies are needed to define the values that can predict long-term outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

• 대한영상의학회지
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• 제84권3호
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• pp.536-549
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• 2023

염증성 장질환의 두 가지 주요 질환으로 크론병과 궤양성 대장염이 있다. 염증성 장질환이 의심될 때, 최근에는 장벽과 장벽 밖을 모두 평가할 수 있고 다른 질환과의 감별에도 도움을 받을 수 있어 CT 소장조영술이 초기 영상검사로 널리 사용되고 있다. 염증성 장질환이 의심되는 경우, 크론병과 궤양성 대장염과의 구분이 필요하며 대부분의 경우 어렵지 않게 구분이 되나 그렇지 않은 경우가 있어 이를 염증성 장질환-미분류(inflammatory bowel diseaseunclassified)로 구분한다. 궤양성 대장염의 경우 CT 소견은 비특이적인 경우가 많아 영상검사만으로 다른 질환과 감별하기 어려운 경우가 많다. 크론병의 경우 특징적인 CT 소견이 진단에 도움이 되는 경우가 많으나 이를 모방하는 질환들이 있으며 특히 결핵성 장염은 여전히 크론병과 감별이 어려울 수 있다. 최근에는 크론병과 유사한 다발성 궤양과 협착이 있는 환자의 일부에서 SLCO2A1이라는 프로스타글란딘 수송체를 암호화하는 유전자의 돌연변이가 질환의 원인인 것으로 밝혀져 크론병과 감별하기 위해 유전자 검사가 시행되고 있다.

• 생약학회지
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• 제51권2호
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• pp.107-114
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• 2020

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder on the large intestine that has been considered as an incurable not only in Western society but also in Eastern Asia in recent years. Despite enormous efforts to develop novel therapeutics for this disease, strategy using bioactive compounds from natural product is still considered as important. p-hydroxycinnamic acid (HCA) is an intermediate substance found in several plants and has been known to possess anti-inflammation but little evidence is reported whether HCA has an inhibitory effect on intestinal inflammation. In the present study, we observed HCA does not show cytotoxic and apoptotic in HT-29 cells. Quantitative PCR analysis revealed that HCA effectively blocks the activity of HT-29 cells stimulated with TNF-α treatment. HCA inhibits translocation of p65 and MAPK pathways in activated HT-29 cells by TNF-α treatment. Besides, oral administration of HCA attenuates manifestation of DSS-induced inflammatory disease in vivo. Histological analysis exhibited that oral administration of HCA recovers IBD symptoms. The expression of pro-inflammatory cytokines were reduced by oral administration of HCA on intestinal tissues. Therefore, these results suggest that HCA has a potent anti-inflammatory effect on intestinal cells as well as show a therapeutic potential for treating IBD in vivo.