Topic
Ulcerative colitis
About: Ulcerative colitis is a research topic. Over the lifetime, 29047 publications have been published within this topic receiving 872421 citations. The topic is also known as: hemorrhagic colitis & Ulcerative Colitis.
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TL;DR: Patient stratification by GI microbiota provides further evidence that CD represents a spectrum of disease states and suggests that treatment of some forms of IBD may be facilitated by redress of the detected microbiological imbalances.
Abstract: The two primary human inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), are idiopathic relapsing disorders characterized by chronic inflammation of the intestinal tract. Although several lines of reasoning suggest that gastrointestinal (GI) microbes influence inflammatory bowel disease (IBD) pathogenesis, the types of microbes involved have not been adequately described. Here we report the results of a culture-independent rRNA sequence analysis of GI tissue samples obtained from CD and UC patients, as well as non-IBD controls. Specimens were obtained through surgery from a variety of intestinal sites and included both pathologically normal and abnormal states. Our results provide comprehensive molecular-based analysis of the microbiota of the human small intestine. Comparison of clone libraries reveals statistically significant differences between the microbiotas of CD and UC patients and those of non-IBD controls. Significantly, our results indicate that a subset of CD and UC samples contained abnormal GI microbiotas, characterized by depletion of commensal bacteria, notably members of the phyla Firmicutes and Bacteroidetes. Patient stratification by GI microbiota provides further evidence that CD represents a spectrum of disease states and suggests that treatment of some forms of IBD may be facilitated by redress of the detected microbiological imbalances.
3,967 citations
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TL;DR: Patients with moderate-to-severe active ulcerative colitis treated with infliximab at weeks 0, 2, and 6 and every eight weeks thereafter were more likely to have a clinical response at weeks 8, 30, and 54 than were those receiving placebo.
Abstract: Background Infliximab, a chimeric monoclonal antibody directed against tumor necrosis factor α, is an established treatment for Crohn's disease but not ulcerative colitis. Methods Two randomized, double-blind, placebo-controlled studies — the Active Ulcerative Colitis Trials 1 and 2 (ACT 1 and ACT 2, respectively) — evaluated the efficacy of infliximab for induction and maintenance therapy in adults with ulcerative colitis. In each study, 364 patients with moderate-to-severe active ulcerative colitis despite treatment with concurrent medications received placebo or infliximab (5 mg or 10 mg per kilogram of body weight) intravenously at weeks 0, 2, and 6 and then every eight weeks through week 46 (in ACT 1) or week 22 (in ACT 2). Patients were followed for 54 weeks in ACT 1 and 30 weeks in ACT 2. Results In ACT 1, 69 percent of patients who received 5 mg of infliximab and 61 percent of those who received 10 mg had a clinical response at week 8, as compared with 37 percent of those who received placebo (P<0...
3,345 citations
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TL;DR: Overall, incidence appeared to be on the rise worldwide and peak incidence occurred in the second to fourth decade of life, although a modest rise was also seen in later life, and no consistent difference was seen between the sexes.
Abstract: developing countries. It has been proposed that this is the result of improved hygiene and sanitation, which have led to reduced exposure to enteric infections and immaturity of the immune system. In a recent systematic review of population based studies, incidence varied from 0.6 to more than 20 people per 100 000 person years in Europe and North America, compared with 0.1 to 6.3 per 100 000 person years in Asia and the Middle East. Overall, incidence appeared to be on the rise worldwide. Peak incidence occurred in the second to fourth decade of life, although a modest rise was also seen in later life. Prevalence was estimated at 5-500 people per 100 000 worldwide. No consistent difference was seen between the sexes. Smoking protects against developing ulcerative colitis. Risk is eight times higher in first degree relatives of people with the disorder compared with first degree relatives of healthy controls, although this is not completely explained by known genetic risk factors.
3,187 citations
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TL;DR: The changing incidence and prevalence of inflammatory bowel disease around the world has become a global disease with accelerating incidence in newly industrialised countries whose societies have become more westernised and burden remains high as prevalence surpasses 0·3%.
3,176 citations
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University of Pittsburgh1, Cedars-Sinai Medical Center2, Johns Hopkins University3, Johns Hopkins University School of Medicine4, Université de Montréal5, Broad Institute6, University of Toronto7, Harvard University8, University of Chicago9, McGill University10, North Shore-LIJ Health System11, Yale University12
TL;DR: A highly significant association is found between Crohn's disease and the IL23R gene on chromosome 1p31, which encodes a subunit of the receptor for the proinflammatory cytokine interleukin-23, which prioritize this signaling pathway as a therapeutic target in inflammatory bowel disease.
Abstract: The inflammatory bowel diseases Crohn's disease and ulcerative colitis are common, chronic disorders that cause abdominal pain, diarrhea, and gastrointestinal bleeding. To identify genetic factors that might contribute to these disorders, we performed a genome-wide association study. We found a highly significant association between Crohn's disease and the IL23R gene on chromosome 1p31, which encodes a subunit of the receptor for the proinflammatory cytokine interleukin-23. An uncommon coding variant (rs11209026, c.1142G>A, p.Arg381Gln) confers strong protection against Crohn's disease, and additional noncoding IL23R variants are independently associated. Replication studies confirmed IL23R associations in independent cohorts of patients with Crohn's disease or ulcerative colitis. These results and previous studies on the proinflammatory role of IL-23 prioritize this signaling pathway as a therapeutic target in inflammatory bowel disease.
2,937 citations