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Intestinal research (Intest Res) update

  • : 대한장연구학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
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  • : 1598-9100
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수록정보
수록범위 : 1권1호(2003)~19권4호(2021) |수록논문 수 : 862
Intestinal research (Intest Res)
19권4호(2021년 10월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

1Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?

저자 : You Sun Kim

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 357-359 (3 pages)

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2Gut microbiome and checkpoint inhibitor colitis

저자 : Kanika Sehgal , Sahil Khanna

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 360-364 (5 pages)

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Immune checkpoint inhibitor therapies such as ipilimumab, are increasingly being used as a treatment option for a variety of cancers, including metastatic melanoma and have demonstrated effectively a prolonged survival. These agents have an im-munological mode of action that predisposes patients to a number of immune-related adverse events, colitis being one of the most commonly encountered complications. The pathogenesis for the development of colitis is unclear, and there is a growing consensus that the ecosystem of the gastrointestinal microbiota plays a significant role. Based on this suspected connection, studies are being carried out to explore the changes in the microbiota in patients on these medications who develop colitis. Conceivably, the modulation of the gut microbiota could offer a therapeutic benefit. Fecal microbiota transplantation is one therapeutic option that is currently being investigated, though there are still more data needed to evaluate its efficacy. In this review, we recapitulate the mechanisms of action of immune checkpoint inhibitors, their adverse events, with a focus on colitis and the role gut microbiota are suspected to play, and finally discuss the microbiota modulation therapies being investigated. (Intest Res 2021;19:360-364 )

KCI등재 SCOPUS

3Crohn's disease at radiological imaging: focus on techniques and intestinal tract

저자 : Giuseppe Cicero , Silvio Mazziotti

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 365-378 (14 pages)

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Over recent years, inflammatory bowel diseases have become an issue of increased attention in daily clinical practice, due to both a rising incidence and improved imaging capability in detection. In particular, the diagnosis of Crohn's disease is based on clinical picture, laboratory tests and colonoscopy with biopsy. However, colonoscopic evaluation is limited to the mucosal layer. Thus, imaging modalities play a pivotal role in enriching the clinical picture, delivering information on intestinal and extraint-estinal involvement. All the imaging modalities can be employed in evaluation of Crohn's disease patients, each of them with specific strengths as well as limitations. In this wide selection, the choice of a proper diagnostic framework can be challenging for the clinician. Therefore, the aim of this work is to offer an overview of the different imaging techniques, with brief technical details and diagnostic potential related to each intestinal tract. (Intest Res 2021;19:365-378)

KCI등재 SCOPUS

4An overview of the gut side of the SARS-CoV-2 infection

저자 : Bruna Barbosa Da Luz , Natalia Mulinari Turin De Oliveira , Isabella Wzorek França Dos Santos , Luana Zampieron Paza , Lara Luisa Valerio De Mello Braga , Fernanda Da Silva Platner , Maria Fernanda De Paula Werner , Elizabeth

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 379-385 (7 pages)

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In late 2019, an outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) initiated in Wuhan, Hubei province, China. The major clinical symptoms described for coronavirus disease (COVID-19) include respira-tory distress and pneumonia in severe cases, and some patients may experience gastrointestinal impairments. In accordance, viral RNA or live infectious virus have been detected in feces of patients with COVID-19. Binding of SARS-CoV-2 to the angio-tensin-converting enzyme 2 (ACE2) is a vital pathway for the virus entry into human cells, including those of the respiratory mucosa, esophageal epithelium as well as the absorptive enterocytes from ileum and colon. The interaction between SARS- CoV-2 and ACE2 receptor may decrease the receptor expression and disrupt the function of B0AT1 transporter influencing the diarrhea observed in COVID-19 patients. In this context, a fecal-oral transmission route has been considered and points out a role for the digestive tract in disease transmission and severity. Here, in order to further understand the impact of COVID-19 in human physiology, the cellular and molecular mechanisms of SARS-CoV-2 infection and disease severity are discussed in the context of gastrointestinal disturbances. (Intest Res 2021;19:379-385)

KCI등재 SCOPUS

5Efficacy and safety of ustekinumab in East Asian patients with moderately to severely active ulcerative colitis: a subpopulation analysis of global phase 3 induction and maintenance studies (UNIFI)

저자 : Tadakazu Hisamatsu , Hyo Jong Kim , Satoshi Motoya , Yasuo Suzuki , Yoshifumi Ohnishi , Noriyuki Fujii , Nobuko Matsushima , Richuan Zheng , Colleen W. Marano

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 386-404 (19 pages)

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Background/Aims: We aimed to evaluate the efficacy and safety of ustekinumab (UST) in the East-Asian population with mod-erate to severely active ulcerative colitis (UC). Methods: This sub-analysis was conducted on data from East-Asian patients included in the UNIFI program (NCT02407236). UNIFI consisted of two double-blind, placebo-controlled trials: an 8-week induction study and a 44-week randomized withdrawal maintenance study. Results: Of 133 East-Asian patients (Japanese: 107, Korean: 26) who underwent randomization, 131 completed induction study and 111 entered maintenance study. In the main-tenance study, 78 patients were randomized. Patients who received UST 130 mg and UST 6 mg/kg showed numerically higher clinical remission at week 8 in the induction study (5/44 [11.4%] and 5/45 [11.1%], respectively) compared with those who re-ceived placebo (0/44, 0%). The proportion of patients achieved clinical remission at week 44 was numerically higher in the UST 90 mg q12w group (10/21, 47.6%), but similar in the UST 90 mg q8w group (5/26, 19.2%) compared to placebo (7/31, 22.6%). Serious adverse events were reported in 1 patient in UST 130 mg group, but no patient in UST 6 mg/kg group through week 8 in the induction study, and 1 patient in UST 90 mg q12w group and 5 patients in the UST 90 mg q8w group in the maintenance study. No deaths were reported in East-Asian patients throughout the study. Conclusions: UST induction and maintenance treatments were effective in East-Asian patients with moderate to severe UC; the efficacy and safety profiles were consistent with the overall population. (Intest Res 2021;19:386-397)

KCI등재 SCOPUS

6Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease

저자 : Rupa Banerjee , Partha Pal , Zaheer Nabi , Upender Shava , Girish Ganesh , D. Nageshwar Reddy

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 398-411 (14 pages)

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Background/Aims: Information on pediatric inflammatory bowel disease (PIBD) and very early onset IBD (VEOIBD) are sparse in India, where IBD is emerging. We aimed to evaluate characteristics of VEOIBD and later onset PIBD (LO-PIBD) in India. Methods: We performed retrospective analysis of a large, prospectively maintained IBD registry. PIBD was divided in to VEOIBD (<6 years) and LO-PIBD (6-17 years). Demographic data, disease characteristics and treatment were compared between the PIBD groups and with other Asian/Western studies as well as the adult patients of the registry. Results: Of 3,752 IBD patients, 292 (7.8%) had PIBD (0-17 years) (175 Crohn's disease [CD], 113 ulcerative colitis [UC], 4 IBD-undifferentiated; 22 VEOIBD [7.5%], and 270 LO-PIBD [92.5%]). VEOIBD patients had more severe disease compared to LO-PIBD in both UC (P= 0.003) and CD (P< 0.001). Familial IBD was more common in VEOIBD (13.6%) compared to LO-PIBD (9.2%). Ileal disease (L1) was an independent risk factor for diagnostic delay in pediatric CD. Diagnostic delay ( >6 months) was significantly lower in VEOIBD (40.9%) than in LO-PIBD (78.8%) (P< 0.001). Compared to other Asian and Western studies, extensive UC (72.5%) and complicated CD (stricturing/penetrating: 42.7%) were relatively more common. Perianal CD was relatively less frequent (7.4%). PIBD had a significantly higher number of complicated and ileal CD and extensive UC comparison to adult cohort of the registry. Conclusions: VEOIBD has more aggressive phenotype than LO-PIBD. Disease appears distinct from other Asian and Western studies and adult onset disease, with more complicated CD and extensive UC. (Intest Res 2021;19:398-407)

KCI등재 SCOPUS

7Long-term safety and effectiveness of adalimumab in Japanese patients with Crohn's disease: 3-year results from a real-world study

저자 : Tadakazu Hisamatsu , Yasuo Suzuki , Mariko Kobayashi , Takashi Hagiwara , Takeshi Kawaberi , Haruhiko Ogata , Toshiyuki Matsui , Mamoru Watanabe , Toshifumi Hibi

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 408-418 (11 pages)

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Background/Aims: Crohn's disease is a chronic disorder; therefore, it is essential to investigate long-term safety and efficacy of treatments. This study assessed the safety and effectiveness of adalimumab for up to 3 years in Japanese patients with Crohn's disease in real-world settings. Methods: This was a multicenter, single-cohort, observational study of patients with Crohn's disease. Safety assessments included incidence of adverse drug reactions. Effectiveness assessments included clinical remis-sion, mucosal healing, and Work Productivity and Activity Impairment (WPAI). Results: The safety and effectiveness analysis populations comprised 389 and 310 patients, respectively. Mean (standard deviation) exposure to adalimumab in the safety analysis population was 793.4 (402.8) days, with a 58.1% retention rate. A total of 105 patients (27.0%) and 43 patients (11.1%) experienced adverse drug reactions and serious adverse drug reactions, respectively, with no patient reporting tuberculosis or hepatitis B. Infections and serious infections were reported in 37 patients (9.5%) and 17 patients (4.4%), respectively. Malig-nancy was reported as an adverse drug reaction in 2 patients (0.5%). Remission rate increased from 37.8% (98/259) at baseline to 73.9% (167/226) at week 4 and remained >70% over 3 years. Proportion of patients without mucosal ulcerations increased from 2.7% (2/73) at baseline to 42.3% (11/26) between years >2 to ≤3. WPAI improvement started at 4 weeks, with the overall work impairment score improving from 42.7 (n=102) at baseline to 26.9 (n=84) at 4 weeks. Conclusions: Results from this study confirm the long-term safety and effectiveness of adalimumab treatment in Japanese patients with Crohn's disease in the real-world setting. (Intest Res 2021;19:408-418)

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8Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study

저자 : Haruhiko Ogata , Takashi Hagiwara , Takeshi Kawaberi , Mariko Kobayashi , Toshifumi Hibi

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 419-429 (11 pages)

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Background/Aims: Adalimumab has been shown to induce and maintain clinical remission in patients with moderate to se-vere ulcerative colitis (UC). However, no large-scale population-based studies have been performed in Japan. This study was conducted to evaluate the safety and effectiveness of adalimumab in clinical practice in Japanese patients with UC. Methods: In this 52-week, prospective, multicenter, single-cohort, noninterventional, observational, postmarketing surveillance study, patients with moderate to severe UC received an initial subcutaneous injection of adalimumab 160 mg, followed by 80 mg at 2 weeks, and then 40 mg every other week. Safety assessments were the incidence of adverse drug reactions (ADRs) and seri-ous ADRs. Effectiveness assessments were clinical remission, corticosteroid-free remission, mucosal healing, and change in C-reactive protein (CRP) levels from baseline. Results: Of 1,593 registered patients, 1,523 (male, 57.6%; mean age, 41.8 years) and 1,241 patients were included in the safety and effectiveness populations, respectively. ADRs were reported in 18.1% and serious ADRs in 4.9% of patients. Clinical remission was achieved in 49.7% of patients at week 4, increasing to 74.4% at week 52. Corticosteroid-free remission rates increased over time, from 10.4% at week 4 to 53.1% at week 52. More than 60% of patients demonstrated mucosal healing at weeks 24 and 52. Mean CRP levels (mg/dL) decreased from 1.2 at baseline to 0.6 at week 4 and 0.3 at week 52. Conclusions: This large real-world study confirmed the safety and effectiveness of adalimumab in patients with UC in Japan. No new safety concerns were identified. (Intest Res 2021;19:419-429)

KCI등재 SCOPUS

9Clinical characteristics of inflammatory bowel disease patients with immunoglobulin A nephropathy

저자 : Ryohei Hayashi , Yoshitaka Ueno , Shinji Tanaka , Kana Onishi , Takeshi Takasago , Masaki Wakai , Toshikatsu Naito , Kensuke Sasaki , Shigehiro Doi , Takao Masaki , Kazuaki Chayama

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 430-437 (8 pages)

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Background/Aims: Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract. Some patients with this condition have been reported to present with immunoglobulin A nephropathy (IgAN), a renal complication that can cause end-stage renal failure, but the frequency of this comorbidity has not been described. Thus, the aim of this study was to investigate the frequency of IgAN in patients with IBD. Methods: This study included 620 patients with IBD (338 with ulcer-ative colitis [UC] and 282 with Crohn's disease [CD]) from the Hiroshima University Hospital outpatient department. IgAN cases were identified from medical interviews, blood examinations (serum immunoglobulin A), and urinalyses (occult blood, proteinuria). Definitive IgAN cases were diagnosed by renal biopsies, while those detected through the clinical course and test results, but not clinically recommended for renal biopsy, were defined as suspected IgAN. Results: We analyzed 427 cases meeting the inclusion criteria (220 with UC and 207 with CD). The incidence of IgAN across all patients with IBD was 3.0%. The frequency of IgAN was significantly higher in patients with CD (11/207, 5.3%) than in those with UC (2/220, 0.9%) (P< 0.01). Moreover, a significant correlation was found between CD patients with ileostomy or colostomy and a diagnosis of IgAN. Con-clusions: Patients with IBD present a high incidence of IgAN, especially those with CD who have undergone ileostomy or co-lostomy. (Intest Res 2021;19:430-437)

KCI등재 SCOPUS

10High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis

저자 : Saransh Jain , Divya Namdeo , Pabitra Sahu , Saurabh Kedia , Peush Sahni , Prasenjit Das , Raju Sharma , Vipin Gupta , Govind Makharia , Lalit Dar , Simon Pl Travis , Vineet Ahuja

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 4호 발행 연도 : 2021 페이지 : pp. 438-448 (11 pages)

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Background/Aims: Predictors of short-term outcome of intravenous (IV) steroid therapy in acute severe ulcerative colitis (ASUC) have been well described, but the impact of cytomegalovirus (CMV) infection as a predictor of outcome remains debatable. We investigated the role of quantitative CMV polymerase chain reaction (PCR) as a predictor of short-term outcome in patients with ASUC. Methods: Consecutive patients with ASUC satisfying Truelove and Witts criteria hospitalized at All India Institute of Medical Sciences (AIIMS) from May 2016 to July 2019 were included; all received IV steroid. The primary outcome measure was steroid-failure defined as the need for rescue therapy (with ciclosporin or infliximab) or colectomy during admission. AIIMS' in-dex (ulcerative colitis index of severity >6 at day 1+fecal calprotectin >1,000 μg/g at day 3), with quantitative CMV PCR on biopsy samples obtained at initial sigmoidoscopy were correlated with the primary outcome. Results: Thirty of 76 patients (39%) failed IV corticosteroids and 12 (16%) underwent surgery. Patients with steroid failure had a significantly higher mucosal CMV DNA than responders (3,454 copies/mg [0-2,700,000] vs. 116 copies/mg [0-27,220]; P< 0.01). On multivariable analysis, mucosal CMV DNA load >2,000 copies/mg (odds ratio [OR], 10.2; 95% confidence interval [CI], 2.6-39.7; P<0.01) and AIIMS' index (OR, 39.8; 95% CI, 4.4-364.4; P< 0.01) were independent predictors of steroid-failure and need for colectomy. The combination correctly predicted outcomes in 84% of patients with ASUC. Conclusions: High mucosal CMV DNA ( >2,000 copies/mg) independently predicts failure of IV corticosteroids and short-term risk of colectomy and it has an additional value to the established markers of disease severity in patients with ASUC. (Intest Res 2021;19:438-447)

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