The word constipation comes from the Latin constipare meaning "to press, crowd together", and from 1400 A.D. Latin Constipationem. According to Medilexicon's medical dictionary, constipation is "A condition in which bowel movements are infrequent or incomplete". Constipation is also known as costiveness, and irregularity.
Constipation is a condition of the digestive system. The sufferer has hard feces that are difficult to expel. In most cases, this occurs because the colon has absorbed too much of the water from the food that is in the colon. The slower the food moves through your digestive tract, the more water the colon will absorb from food. Consequently, the feces become dry and hard. Defecation (emptying the bowels) can become very painful, and in some serious cases there may be symptoms of bowel obstruction. When the constipation is very severe; when the constipation prevents the passage of feces and gas, it is called obstipation.
What causes constipation?
Constipation happens when the colon absorbs too much water, or if the muscles in the colon are contracting slowly or poorly so that the stool moves too slowly and loses more water.
Interesting articles
What are laxatives? Do laxatives work?
What is fiber? What is dietary fiber? Fiber rich foods.
What is a balanced fluid intake?
All about opioids and opioid induced constipation
What is irritable bowel syndrome (IBS)? What are the symptoms of IBS?
What is Crohn's disease? What causes Crohn's disease?
Here are the most common causes of constipation:
The sufferer's diet is lacking in adequate quantities of fiber
It is well known that people whose diets include a good quantity of fiber are significantly less likely to suffer from constipation. Foods low in fiber are high fat foods, such as cheese, meats, and eggs. If you consume them, make sure you are also eating enough fruits, vegetables, and whole grains - which are rich in fiber.
There are two main types of fiber, soluble and insoluble. Soluble dissolves in water, while insoluble doesn't. Fiber cannot be digested. However, soluble fiber is transformed as it passes through the digestive tract, where it is fermented by bacteria. Soluble fiber absorbs water, and becomes gelatinous as it does so. Insoluble fiber passes through the gut without changing its form.
Quite simply, fiber promotes bowel movements and prevents constipation. Studies have indicated, however, that fiber is not that useful in dealing with constipation, it is better at preventing it.
The sufferer is too physically inactive. This is especially the case if the person is elderly
We know that if somebody has had to lie down in bed for a long time, perhaps for several days or weeks, his/her risk of having constipation is significantly increased. Experts are not sure why. Some say that physical activity keeps our metabolism high, making most things in our bodies happen more rapidly. Elderly people tend to have a more sedentary life, compared to younger, people, and are therefore at higher risk of constipation. Physically active people are much less likely to become constipated than inactive people.
Some drugs
It is common for people to forget that there are a lot of medications that can cause constipation. The most common ones are:
-- Narcotic (opioid) pain drugs, such as codeine (Tylenol#3), oxycodone (Percocet), and hydromorphone (Dilaudid)
-- Antidepressants, such as amitriptyline (Elavil) and imipramine (Tofranil)
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-- Anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol)
Iron supplements
-- Calcium channel blocking drugs such as diltiazem (Cardizem) and nifedipine (Procardia)
-- Aluminum-containing antacids such as Amphojel and Basaljel
-- Diuretics such as chlorothiazide (Diuril)
Milk
Some people become constipated when they consume mild and dairy products.
IBS (irritable bowel syndrome)
People who suffer from IBS get constipation much more frequently, compared to the rest of the population.
Pregnancy
Pregnancy brings about hormonal changes which can make a woman more susceptible to constipation. Also, the uterus may compress the intestine, slowing down the passage of the food.
Aging
As we get older our metabolism slows down, resulting in less intestinal activity. The muscles in the digestive tract do not work as well as they used to.
A change in routine, such as when travelling
When we travel our normal routine changes. This can have an effect on our digestive system, which sometimes results in constipation. Meals are eaten at different times, we might go to bed, get up, and go to the toilet at different times. All these changes may raise the risk of constipation.
Overuse of laxatives
We all think we should go to the toilet at least once a day - this is a myth. To make sure that happens many people self-medicate with laxatives products they buy at the pharmacy. Laxatives are effective; they do help bowel movements. The problem is that if we keep taking them we gradually have to up the dose for the same effect. Laxatives can be habit-forming. When we become dependent on them there is a significant risk of constipation when we stop taking them.
Not going to the toilet when you feel the urge to
There can be many reasons for this. Perhaps we are not at home and would prefer to wait till we get back. It is surprising how many people never open their bowels in the toilets at work or at school. Others may be too busy to go, while some people don't because of emotional stress. Children often stop going if they are being toilet trained and find the whole training program nerve-racking. Sometimes children are too busy playing and put off going to the toilet. However, if you ignore the urge to have a bowel movement, that urge can gradually go away until you no longer feel the need to go. The longer you delay it, the drier and harder the stool will become.
Not drinking enough water (dehydration)
Experts say that if you already have constipation, drinking more liquids might not relieve it. However, if you regularly drink plenty of water you are less likely to become constipated. If you tend to suffer regularly from constipation you should seriously consider increasing your consumption of water. Many sodas and drinks containing caffeine may cause dehydration and worsen your constipation. Alcohol also dehydrates the body and should be avoided if you are constipated, or very susceptible to constipation.
Problems with the colon, or rectum
Tumors can compress or restrict the passages and cause constipation. Also scar tissue (adhesions), diverticulosis, and abnormal narrowing of the colon or rectum (colorectal stricture). People with Hirschsprung disease are susceptible to constipation (a birth defect in which some nerve cells are absent in the large intestine. The intestine does move stool through, consequently the intestine becomes blocked, causing the abdomen to enlarge).
Some diseases and conditions
Diseases that tend to slow down the movement of the feces through the colon, rectum, or anus are more likely to cause constipation. They include the following:
Neurological disorders
MS (Multiple Sclerosis), Parkinson's Disease, Stroke, Spinal Cord Injuries, Chronic Idiopathic Intestinal Pseudo-Obstruction
Endocrine and metabolic conditions
Uremia, Diabetes, Hypercalcemia, Poor Glycemic Control, Hypothyroidism
Systemic diseases (Diseases that affect a number of organs and tissues, or affects the body as a whole)
Lupus, scleroderma, and amyloidosis
Cancer
Mainly due to the medications for pain, and chemotherapy. Also if a tumor blocks or squeezes the digestive system.
What is the treatment for constipation?
It is important to remember that the necessity to defecate at least once a day is a myth. Constipation happens when you want to go but are unable to evacuate the feces. In the majority of cases, constipation resolves itself without any treatment or risk to health.
The treatment of recurring constipation can include lifestyle changes. Doing more exercise, eating more fiber, and drinking more water. Some studies contradict the high fiber advice; a study published in the American Journal of Gastroenterology found that the role of dietary fiber to treat chronic constipation is exaggerated. A low fiber diet has been proven not to be the cause of constipation and the success of fiber intake as treatment is modest.
Usually, laxatives will successfully treat most cases of constipation - but should be used with care and only when really necessary. In more difficult cases the person may need a prescription medication. Some people have responded well to biofeedback.
It is important to try to find out what has caused the constipation is in the first place - there could be an underlying illness or condition. Some people with recurring constipation use a daily diary where they record their bowel movements, stool characteristics, and other factors which may help both the doctor and patient devise the best treatment.
Some gastroenterologists comment that there are people who do not allocate enough time for their defecation. Set aside enough time to allow your toilet visit to be unstressed and uninterrupted, and do not ignore an urge to have a bowel movement.
Over-the-Counter laxatives
Only use these laxatives as a last resort. They can be habit forming, as was mentioned above:
Stimulants - they make the muscles in your intestines contract rhythmically. These include Correctol, Dulcolax and Senokot.
Lubricants - they help the stool move down the colon more easily. These include mineral oil and Fleet.
Stool softeners - they rehydrate (moisten) the stool. These include Colace and Surfak.
Fiber supplements - these are perhaps the safest laxatives. They are also called bulk laxatives. These include FiberCon, Metamucil, Konsyl, Serutan and Citrucel. Make sure you have plenty of water when you take them.
Osmotics - they facilitate the movement of fluids through the colon. These include Cephulac, Sorbitol, and Miralax.
Saline laxatives - they draw water into the colon. These include milk of magnesia.
Choride channel activators - these require a prescription. These include lubiprostone (Amitiza).
.
5-HT-4 agonists - they increase the secretion of fluid in the intestines, and also speed up the rate at which food passes through the colon. These include Prucalopride.
Relistor was approved by the FDA in April, 2008 for the treatment of opioid-induced constipation. Opioids are commonly prescribed on a continuous basis for patients with late-stage, advanced illness to help alleviate pain.
If your doctor identifies an underlying disorder that may be causing your constipation he/she will treat that disorder.
If you have pelvic floor dysfunction, you may be treated with biofeedback. It is a retraining technique that helps you learn how to coordinate the muscles appropriately so that you have a successful bowel movement.
If the constipation does not respond to any treatment, as a last resort it might be recommendable to remove part of the colon. When this happens the troublesome segment(s) of the anal sphincter or rectum are removed.
How common is constipation?
Among children
According to research carried out at Nationwide Children's Hospital, Columbus, Ohio, the burden of illness in children suffering from constipation, and the costs associated with this condition, are roughly of the same magnitude as those for asthma and attention deficit-hyperactivity disorder (ADHD). According to researchers at the University of Iowa, constipation is the most common cause of children's abdominal pain.
Adults and people in general
According to a presentation by Boehringer Ingelheim, data show that 12% of people worldwide suffer from self-defined constipation. The figure varies depending on the region; people in the Americas and Asia Pacific suffer twice as much as their European counterparts, where the incidence of constipation is lowest (Americas and Asia Pacific mean 17.3% -v- European mean 8.75%).
According to a study carried out by the University of Iowa, chronic constipation affects 15% to 20% of the U.S. population.
Further reading
суббота, 30 июля 2011 г.
суббота, 23 июля 2011 г.
ACR's Guidelines For CT Colonography Interpretation Examined In Study At Digestive Disease Week
A study presented at Digestive Disease Week® 2008 examined the American College of Radiology's (ACR) CT colonography guidelines recommending that polyps up to 5mm in size not be reported on CT colonography by applying them to an endoscopic database that collected information about polyps that had been removed and processed. The guidelines also recommend that patients with one or two polyps 6 to 9 mm in size and no larger polyps can have repeat CT colonography in three years rather than prompt polypectomy. The database included information for 10,780 polyps removed from 5,079 patients (among 10,034 colonoscopies) over a five-year interval. Overall, the study determined that if CT colonography rather than colonoscopy had been used in this population, and assuming 100 percent sensitivity of CT colonography for polyps ?‰? 6 mm and ACR interpretation recommendations, then 29 percent of all patients and 30 percent of patients over age 50 with high risk adenoma findings would have been interpreted as normal. High risk adenoma findings were defined according to current post-polypectomy surveillance guidelines as any adenoma 1 cm or larger in size, any adenoma with high grade dysplasia or villous elements, or patients with three or more adenomas of any size. An additional 18 percent of both groups could have had polypectomy delayed for at least three years.
The study, "American College of Radiology (ACR) Recommendations for CT Colonography (CTC) Interpretation: Implications for Resection of High Risk Adenoma Findings," was presented by Douglas K. Rex, MD, FASGE, chancellors professor of medicine, Indiana University School of Medicine and director of endoscopy at Indiana University Hospital, who also presented other research during DDW® on large sessile adenomas and their association with a high prevalence of synchronous neoplasia.
Large Sessile Adenomas Are Associated with a High Prevalence of Synchronous Neoplasia
In this study, patients with large (?‰? 2cm) sessile adenomas who undergo piecemeal endoscopic resection are recommended to have a follow up examination in three to six months to examine the polypectomy site for residual disease. The study was a retrospective single academic center review of synchronous neoplastic findings in 190 consecutive patients with intact colons and single large sessile adenomas resected endoscopically. All included patients had at least one full colonoscopy. Synchronous polyps were those removed at the same colonoscopy that discovered the large sessile adenoma, or at any follow up endoscopic examination within 12 months of discovery of the large sessile adenoma.
Researchers found that 75 percent of patients had at least one synchronous adenoma, and the 190 patients had an average of four synchronous adenomas. Thirty percent of patients had at least one synchronous advanced adenoma (adenoma ?‰?1 cm in size, or with high grade dysplasia or villous element), and three percent had synchronous lesions with high-grade dysplasia. Synchronous disease was distributed throughout the colon and was likely to be in a distant colonic segment as in the same or an adjacent colonic segment. Researchers concluded that patients with large sessile adenomas resected endoscopically warrant follow up not only to ensure complete resection, but also to ensure clearing of the entire colon.
Preoperative Detection of Familial Pancreatic Neoplasms by Endoscopic Ultrasonography (EUS), Multidetector Computed Tomography (CT) and/or Magnetic Resonance Cholangiopancreatography (MRCP)
Research by Marcia I. Canto, MD, FASGE, associate professor of medicine and oncology, Johns Hopkins University, Baltimore, MD, was presented on the preoperative detection of familial pancreatic neoplasms. Lives can be saved if high grade dysplasia and early familial ductal adenocarcinoma can be detected in high risk individuals before these lesions progress to advanced disease. Researchers looked to characterize pancreatic neoplastic lesions detected by imaging tests in high risk individuals; to compare the diagnostic yield and incremental benefit of EUS over CT/MRCP; and to determine the incremental benefit of fine needle aspiration (FNA) over EUS alone.
Data prospectively collected from 1998-2007 from two screening studies and the center's clinical screening program were analyzed. High risk individuals with Peutz-Jeghers syndrome or first degree relatives from familial ductal adenocarcinoma kindreds with at least two affected, had either multi-detector CT and or MRI/MRCP, and EUS. Radiologic and EUS features of each preoperatively detected lesion were compared with the pathologic findings. The diagnostic yield of each imaging modality was calculated on a per lesion basis.
Of 165 patients who had EUS and CT/MRCP, 19 asymptomatic high risk individuals underwent partial resection (15), partial followed by completion pancreatectomy (3), or total pancreatectomy (1) for 44 pancreatic lesions (size range 2.6-21 mm) detected by EUS, CT or MRCP. Researchers concluded that most pancreatic neoplasms detected by screening tests are small and low grade, but six percent of intraductal papillary mucinous neoplasms < 3 cm may contain high grade dysplasia. EUS detects almost twice as many neoplastic lesions as CT/MRCP, regardless of size, and FNA adds little to EUS.
Peroral Cholangioscopy Guided Stone Therapy - Report of an International Multicenter Registry
A study by Mansour A. Parsi, MD, department of gastroenterology at the Cleveland Clinic Foundation, examined peroral cholangioscopy used for the management of biliary stones that cannot be removed by conventional methods. The need for two expert operators and technical limitations of cholangioscopes has hampered its widespread adoption for the management of difficult to remove biliary stones. Researchers examined the SpyGlass Direct Visualization (SGDVS) system single operator peroral cholangioscope with four-way tip deflection that recently became commercially available. The aim of the study was to evaluate the efficacy and safety of the SGDVS for treatment of difficult to remove biliary stones and assess the utility of the device for detection of missed stones by endoscopic retrograde cholangiography (ERC).
Ninety-eight patients had cholangioscopy guided stone therapy using SGDVS. These patients reflect 33 percent of the cases in a multicenter open-label cholangioscopy registry involving 15 tertiary care centers in the US and Europe in which each patient undergoes ERC immediately followed by cholangioscopy. Procedural indications were bile duct stones not amenable to removal by conventional methods or missed by ERC. Procedural success was defined as the ability to adequately visualize and initiate stone therapy.
Stone location was 56 percent for the common bile duct (CBD), 22 percent for the common hepatic duct (CHD), seven percent for the intrahepatic ducts (IHD), ten percent for the cystic duct, gallbladder was one percent, and the left and right hepatic ducts (LHD and RHD) was four percent. In 59 percent of the cases, stones were impacted, and in 29 percent, stones were reported as missed during the ERC immediately preceding the cholangioscopy. Procedural success was 92 percent in the group as a whole.
DDW® is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW took place May 17-22, 2008, at the San Diego Convention Center, San Diego, Calif. The meeting showcased approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. For more information, visit www.ddwddw/
About the American Society for Gastrointestinal Endoscopy
Founded in 1941, the mission of the American Society for Gastrointestinal Endoscopy is to be the leader in advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with more than 10,000 physician members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asgeasge/ and screen4coloncancer/ for more information.
About Endoscopy
Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system. In many cases, screening or treatment of conditions can be delivered via the endoscope without the need for further sedation, treatment or hospital stay.
Source: Anne Brownsey
American Society for Gastrointestinal Endoscopy
The study, "American College of Radiology (ACR) Recommendations for CT Colonography (CTC) Interpretation: Implications for Resection of High Risk Adenoma Findings," was presented by Douglas K. Rex, MD, FASGE, chancellors professor of medicine, Indiana University School of Medicine and director of endoscopy at Indiana University Hospital, who also presented other research during DDW® on large sessile adenomas and their association with a high prevalence of synchronous neoplasia.
Large Sessile Adenomas Are Associated with a High Prevalence of Synchronous Neoplasia
In this study, patients with large (?‰? 2cm) sessile adenomas who undergo piecemeal endoscopic resection are recommended to have a follow up examination in three to six months to examine the polypectomy site for residual disease. The study was a retrospective single academic center review of synchronous neoplastic findings in 190 consecutive patients with intact colons and single large sessile adenomas resected endoscopically. All included patients had at least one full colonoscopy. Synchronous polyps were those removed at the same colonoscopy that discovered the large sessile adenoma, or at any follow up endoscopic examination within 12 months of discovery of the large sessile adenoma.
Researchers found that 75 percent of patients had at least one synchronous adenoma, and the 190 patients had an average of four synchronous adenomas. Thirty percent of patients had at least one synchronous advanced adenoma (adenoma ?‰?1 cm in size, or with high grade dysplasia or villous element), and three percent had synchronous lesions with high-grade dysplasia. Synchronous disease was distributed throughout the colon and was likely to be in a distant colonic segment as in the same or an adjacent colonic segment. Researchers concluded that patients with large sessile adenomas resected endoscopically warrant follow up not only to ensure complete resection, but also to ensure clearing of the entire colon.
Preoperative Detection of Familial Pancreatic Neoplasms by Endoscopic Ultrasonography (EUS), Multidetector Computed Tomography (CT) and/or Magnetic Resonance Cholangiopancreatography (MRCP)
Research by Marcia I. Canto, MD, FASGE, associate professor of medicine and oncology, Johns Hopkins University, Baltimore, MD, was presented on the preoperative detection of familial pancreatic neoplasms. Lives can be saved if high grade dysplasia and early familial ductal adenocarcinoma can be detected in high risk individuals before these lesions progress to advanced disease. Researchers looked to characterize pancreatic neoplastic lesions detected by imaging tests in high risk individuals; to compare the diagnostic yield and incremental benefit of EUS over CT/MRCP; and to determine the incremental benefit of fine needle aspiration (FNA) over EUS alone.
Data prospectively collected from 1998-2007 from two screening studies and the center's clinical screening program were analyzed. High risk individuals with Peutz-Jeghers syndrome or first degree relatives from familial ductal adenocarcinoma kindreds with at least two affected, had either multi-detector CT and or MRI/MRCP, and EUS. Radiologic and EUS features of each preoperatively detected lesion were compared with the pathologic findings. The diagnostic yield of each imaging modality was calculated on a per lesion basis.
Of 165 patients who had EUS and CT/MRCP, 19 asymptomatic high risk individuals underwent partial resection (15), partial followed by completion pancreatectomy (3), or total pancreatectomy (1) for 44 pancreatic lesions (size range 2.6-21 mm) detected by EUS, CT or MRCP. Researchers concluded that most pancreatic neoplasms detected by screening tests are small and low grade, but six percent of intraductal papillary mucinous neoplasms < 3 cm may contain high grade dysplasia. EUS detects almost twice as many neoplastic lesions as CT/MRCP, regardless of size, and FNA adds little to EUS.
Peroral Cholangioscopy Guided Stone Therapy - Report of an International Multicenter Registry
A study by Mansour A. Parsi, MD, department of gastroenterology at the Cleveland Clinic Foundation, examined peroral cholangioscopy used for the management of biliary stones that cannot be removed by conventional methods. The need for two expert operators and technical limitations of cholangioscopes has hampered its widespread adoption for the management of difficult to remove biliary stones. Researchers examined the SpyGlass Direct Visualization (SGDVS) system single operator peroral cholangioscope with four-way tip deflection that recently became commercially available. The aim of the study was to evaluate the efficacy and safety of the SGDVS for treatment of difficult to remove biliary stones and assess the utility of the device for detection of missed stones by endoscopic retrograde cholangiography (ERC).
Ninety-eight patients had cholangioscopy guided stone therapy using SGDVS. These patients reflect 33 percent of the cases in a multicenter open-label cholangioscopy registry involving 15 tertiary care centers in the US and Europe in which each patient undergoes ERC immediately followed by cholangioscopy. Procedural indications were bile duct stones not amenable to removal by conventional methods or missed by ERC. Procedural success was defined as the ability to adequately visualize and initiate stone therapy.
Stone location was 56 percent for the common bile duct (CBD), 22 percent for the common hepatic duct (CHD), seven percent for the intrahepatic ducts (IHD), ten percent for the cystic duct, gallbladder was one percent, and the left and right hepatic ducts (LHD and RHD) was four percent. In 59 percent of the cases, stones were impacted, and in 29 percent, stones were reported as missed during the ERC immediately preceding the cholangioscopy. Procedural success was 92 percent in the group as a whole.
DDW® is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW took place May 17-22, 2008, at the San Diego Convention Center, San Diego, Calif. The meeting showcased approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology. For more information, visit www.ddwddw/
About the American Society for Gastrointestinal Endoscopy
Founded in 1941, the mission of the American Society for Gastrointestinal Endoscopy is to be the leader in advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with more than 10,000 physician members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asgeasge/ and screen4coloncancer/ for more information.
About Endoscopy
Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system. In many cases, screening or treatment of conditions can be delivered via the endoscope without the need for further sedation, treatment or hospital stay.
Source: Anne Brownsey
American Society for Gastrointestinal Endoscopy
суббота, 16 июля 2011 г.
CEA-Leti And 7 Partners To Study Ways To Improve Treatment Of Inflammatory Bowel Disease
CEA-Leti today announced a new project designed to develop a novel nanocarrier-based approach to improve the treatment of inflammatory bowel disease, and increasingly common condition in Europe.
The Delivering Nano-pharmaceuticals through Biological Barriers project, known as BIBA, involves eight partners in France, Germany, Spain and Switzerland. BIBA is coordinated by CEA-Leti as part of its research program on organic nanocarriers and delivery systems for clinical applications like molecular imaging and drug delivery.
The three-year study is designed to develop an anti-inflammatory corticoid and/or an immunosuppressant encapsulated within a biodegradable nanocarrier for improved treatment of IBD and reduced side effects. Industry supervision of the preclinical proof of concept will enhance quality control to guaranty a faster regulatory application after the project.
Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). Medical treatment of IBD is mostly based on the use of corticosteroid to induce remission and of an immunosuppressant to prevent relapses. But these approaches are inefficient in more than 70 percent of patients with CD, and 20 percent of the patients with UC who ultimately require surgery for control of the disease. Corticosteroids like prednisolone can induce remission in a high proportion (60-80 percent) of patients.
However, the required doses of steroids cannot be administered long-time due to adverse events. BIBA will investigate local delivery of encapsulated corticosteroids and immunosuppressants using two types of organic biodegradable nanocarriers to prevent side effects. Passive targeting of nano-delivery systems in inflamed tissues exploiting the so-called enhanced permeability and retention (EPR) effect is expected to increase the local concentration of cortico??ds in inflamed areas.
One model of corticoid, budesonide, and one model of immunosuppressant, cyclosporine, will be separately encapsulated in three dosage forms - oral, colonic, and intravenous - to maximise the delivery of anti-inflammatory drugs through the gastrointestinal tract, with two nanocarriers: lipid "baby bubbles" (Lipidots®) and poly(lactic-co-glycolic acid) (PLGA) particles. In vitro experiments will be performed on a lab model of healthy and pathological epithelium to screen the most relevant nano-pharmaceuticals.
Formulations will then be evaluated in vivo in appropriate rodent colitis models. Animal models allow both the examination of inflammatory processes (both early and late events) as well as the evaluation of new therapeutic modalities. Non-invasive magnetic resonance imaging (MRI) and optical fluorescence in combination with histological analysis will be used to monitor the effect of the therapy on the inflamed mucosa.
The BIBA study is funded by the European programme ERANET EuroNanoMed. Leti's partners in the project include:
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrucken, Germany; and PHAST Gesellschaft f??r Pharmazeutische Qualit?¤tstandards mbH, Homburg, Germany
- Institut Albert Bonniot, INSERM-UJF U823, Grenoble, France
- Two Spanish hospitals: Instituto de Investigaci??n Sanitaria La Paz, Madrid; and Institut Investigacions Biom??diques August Pi i Sunyer, Barcelona; and the
- Institute of Anatomy of the University of Zurich
Source:
CEA-Leti
The Delivering Nano-pharmaceuticals through Biological Barriers project, known as BIBA, involves eight partners in France, Germany, Spain and Switzerland. BIBA is coordinated by CEA-Leti as part of its research program on organic nanocarriers and delivery systems for clinical applications like molecular imaging and drug delivery.
The three-year study is designed to develop an anti-inflammatory corticoid and/or an immunosuppressant encapsulated within a biodegradable nanocarrier for improved treatment of IBD and reduced side effects. Industry supervision of the preclinical proof of concept will enhance quality control to guaranty a faster regulatory application after the project.
Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). Medical treatment of IBD is mostly based on the use of corticosteroid to induce remission and of an immunosuppressant to prevent relapses. But these approaches are inefficient in more than 70 percent of patients with CD, and 20 percent of the patients with UC who ultimately require surgery for control of the disease. Corticosteroids like prednisolone can induce remission in a high proportion (60-80 percent) of patients.
However, the required doses of steroids cannot be administered long-time due to adverse events. BIBA will investigate local delivery of encapsulated corticosteroids and immunosuppressants using two types of organic biodegradable nanocarriers to prevent side effects. Passive targeting of nano-delivery systems in inflamed tissues exploiting the so-called enhanced permeability and retention (EPR) effect is expected to increase the local concentration of cortico??ds in inflamed areas.
One model of corticoid, budesonide, and one model of immunosuppressant, cyclosporine, will be separately encapsulated in three dosage forms - oral, colonic, and intravenous - to maximise the delivery of anti-inflammatory drugs through the gastrointestinal tract, with two nanocarriers: lipid "baby bubbles" (Lipidots®) and poly(lactic-co-glycolic acid) (PLGA) particles. In vitro experiments will be performed on a lab model of healthy and pathological epithelium to screen the most relevant nano-pharmaceuticals.
Formulations will then be evaluated in vivo in appropriate rodent colitis models. Animal models allow both the examination of inflammatory processes (both early and late events) as well as the evaluation of new therapeutic modalities. Non-invasive magnetic resonance imaging (MRI) and optical fluorescence in combination with histological analysis will be used to monitor the effect of the therapy on the inflamed mucosa.
The BIBA study is funded by the European programme ERANET EuroNanoMed. Leti's partners in the project include:
- Helmholtz-Institute for Pharmaceutical Research Saarland, Saarbrucken, Germany; and PHAST Gesellschaft f??r Pharmazeutische Qualit?¤tstandards mbH, Homburg, Germany
- Institut Albert Bonniot, INSERM-UJF U823, Grenoble, France
- Two Spanish hospitals: Instituto de Investigaci??n Sanitaria La Paz, Madrid; and Institut Investigacions Biom??diques August Pi i Sunyer, Barcelona; and the
- Institute of Anatomy of the University of Zurich
Source:
CEA-Leti
суббота, 9 июля 2011 г.
New Evidence Supports Non-invasive Routine Screening And Earlier Diagnosis Of Colon Cancer
New results of a pivotal study recently presented at a meeting of the American College of Radiology Imaging Network (ACRIN), showed that Computed Tomography (CT) colonography is at least as sensitive as conventional colonoscopy in detecting adenomas of 1 cm diameter or larger. Adenomas are precursors to colorectal cancer, the second most common cause of death from cancer in the EU with more than 138,000 deaths in 20001. The results of the study are expected to lead to wider adoption of CT colonography (also known as virtual colonoscopy) as routine screening for colorectal cancer. The study, funded by the US National Institutes of Health (NIH), was initiated in 2005 and has involved more than 2,500 asymptomatic patients aged 50 or over at 15 centres across the USA.
The trial compared the detection of polyps and early-stage cancer of the colon using either conventional optical colonoscopy or CT colonography, in which X-ray slice images are reconstructed by computer to provide a virtual image of the colon. Patients were investigated using both procedures and the resulting CT images were read by a panel of radiologists.
Dr Stuart Taylor of University College Hospital, London, a consultant radiologist, commented: "This very well designed study is the largest to date which has specifically investigated the use of CT colonography to screen for colorectal neoplasia in asymptomatic individuals, and has produced very positive results. The 90% sensitivity for identifying patients harbouring a 1 cm adenoma essentially validates the previously reported excellent performance of screening CT colonography by Dr Perry Pickhardt in 2003. I think we can now conclude that, when performed by appropriately trained readers, CT colonography is a viable and robust screening tool for colorectal cancer."
Colonoscopy is widely considered to be the gold-standard method of examining the colon and rectum, but it is expensive, the patient must undergo sedation, and there is a small risk of perforation of the colon, making it unsuitable for large scale population screening2.
David Sumner, Chief Executive of Medicsight, one of the industry leaders in the development of computer-aided detection (CAD) and image analysis software, said: "We welcome the results of this landmark study, confirming our belief that CT colonography is a genuine and robust option in the armamentarium that physicians have at their disposal when screening for colorectal cancer. This is likely to lead to a material increase in the use of CT colonography for screening populations who are most at risk of developing this devastating condition. Medicsight's ColonCAD™ software, which can be used with multi-detector CT imaging equipment, helps radiologists to interpret the CT scans and identify early-stage lesions."
The occurrence of colorectal cancer is strongly related to age, with 83% of cases arising in people who are 60 years or older3. Among individuals diagnosed with colorectal cancer, survival is highly dependent on how advanced the disease is at diagnosis. Five-year survival is 90% if the disease is diagnosed while it affects only the large intestine but only 65% once it has spread to the lymph nodes and 9% if it has spread throughout the body4. Most colorectal cancers arise from precursor lesions in the large intestine called 'adenomatous polyps'. Screening is important because it means that adenomatous polyps can be removed before they become cancerous. Screening also means that colorectal cancer can be diagnosed at an earlier stage4.
There are several methods currently used for colorectal cancer screening and there are advantages and disadvantages associated with all of them. CT colonography is a newer, less invasive method of examining the colon and rectum in which computed tomography is used to generate two- and three-dimensional images of the colon and rectum. Virtual colonoscopy has been found to be as effective at detecting adenomatous polyps as colonoscopy in an earlier study5.
References
1. GLOBOCAN 2000. Cancer Incidence, Mortality and Prevalence Worldwide (2000 estimates).
2. Scholefield JH. ABC of colorectal cancer: screening. BMJ 2000;321(7267):1004-6
3. Cancer Research UK. UK Bowel Cancer incidence statistics. Available here. Accessed on 12 September 2007
4. Smith RA, Mettlin CJ, Eyre H. 31. Cancer Screening and Early Detection. In: D. W. Kufe et al., eds. Cancer Medicine. 6 ed. Hamilton, London: BC Decker Inc, 2003
5. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349(23):2191-200
Medicsight PLC is a UK-based, research driven, leading developer of computer-aided detection (CAD) and image analysis software for the medical imaging market. The CAD software automatically highlights suspicious areas on computerised tomography (CT) scans of the colon and lung, helping radiologists to identify, measure and analyse potential disease and early indicators of disease. Medicsight's computer-aided detection (CAD) software has been validated using one of the world's largest and most population diverse databases of verified patient CT scan data. Medicsight's ColonCAD™ and LungCAD™ software products are seamlessly integrated with the advanced 3D visualisation workstations of several industry-leading imaging equipment partners.
About Computer-Aided Detection
With increasingly sophisticated radiological imaging hardware such as Multi-Detector CT scanners, radiologists are facing a growing challenge in the amount of detailed patient image data that they must review for each patient examination. Some CT scan examinations generate as many as 1000 images per patient. Review of this data by the radiologist is not only time-consuming but also prone to error due to reader fatigue. CAD software can help the reviewing radiologist by analysing the image data and automatically highlighting suspicious regions of interest for closer inspection. Without CAD software some potential abnormalities or areas of disease may be overlooked. This is critical for diagnosis and the management of patient outcomes as early detection of disease greatly increases the probability of successful treatment and a positive therapeutic outcome.
About Medicsight's CAD software
Medicsight's ColonCAD™ and LungCAD™ software use an advanced CAD algorithm to analyse CT scans of the colon and lung and automatically highlight suspicious areas that may be indicators of disease. CAD may highlight areas easily overlooked by the reviewing radiologist, such as small lesions or regions that are hidden from view behind folds in the colon or normal structures and surrounding tissue in the lung.
Both CAD products seamlessly integrate with the advanced 3D visualisation platforms of industry-leading imaging equipment partners. The integrated systems provide sophisticated image viewing capabilities, including 3D reconstructed image data, with the added advantage of demonstrating automatic CAD findings to assist clinical end users in the detection and analysis of disease. This allows clinical end users to perform either a 'second read', where CAD findings are displayed to the user after completion of an initial review of the CT scan data, or a 'concurrent read' where CAD findings are displayed during the user's initial review of the original CT scan images.
Since inception, Medicsight has developed close and lasting relationships with some of the world's foremost clinicians in product related areas. This provides the Company with a wealth of clinical expertise and dedicated clinical research to support ongoing product development. Medicsight also collaborates with a number of leading academic institutions and clinical research programmes worldwide to develop the Company's comprehensive database of population diverse verified patient CT scan data, thus allowing Medicsight's products to be validated to the highest possible standards.
About ACRIN
The American College of Radiology Imaging Network (ACRIN) is a national cancer research organization sponsored and funded by the US National Cancer Institute.
About adenomas
An adenoma (sometimes known as a polyp) is a slow-growing benign tumour. This is the most common type of early-stage tumour found in the colon and typically projects into the colon from the wall. Adenomas are routinely removed on identification because of their tendency to become malignant.
acrin/
The trial compared the detection of polyps and early-stage cancer of the colon using either conventional optical colonoscopy or CT colonography, in which X-ray slice images are reconstructed by computer to provide a virtual image of the colon. Patients were investigated using both procedures and the resulting CT images were read by a panel of radiologists.
Dr Stuart Taylor of University College Hospital, London, a consultant radiologist, commented: "This very well designed study is the largest to date which has specifically investigated the use of CT colonography to screen for colorectal neoplasia in asymptomatic individuals, and has produced very positive results. The 90% sensitivity for identifying patients harbouring a 1 cm adenoma essentially validates the previously reported excellent performance of screening CT colonography by Dr Perry Pickhardt in 2003. I think we can now conclude that, when performed by appropriately trained readers, CT colonography is a viable and robust screening tool for colorectal cancer."
Colonoscopy is widely considered to be the gold-standard method of examining the colon and rectum, but it is expensive, the patient must undergo sedation, and there is a small risk of perforation of the colon, making it unsuitable for large scale population screening2.
David Sumner, Chief Executive of Medicsight, one of the industry leaders in the development of computer-aided detection (CAD) and image analysis software, said: "We welcome the results of this landmark study, confirming our belief that CT colonography is a genuine and robust option in the armamentarium that physicians have at their disposal when screening for colorectal cancer. This is likely to lead to a material increase in the use of CT colonography for screening populations who are most at risk of developing this devastating condition. Medicsight's ColonCAD™ software, which can be used with multi-detector CT imaging equipment, helps radiologists to interpret the CT scans and identify early-stage lesions."
The occurrence of colorectal cancer is strongly related to age, with 83% of cases arising in people who are 60 years or older3. Among individuals diagnosed with colorectal cancer, survival is highly dependent on how advanced the disease is at diagnosis. Five-year survival is 90% if the disease is diagnosed while it affects only the large intestine but only 65% once it has spread to the lymph nodes and 9% if it has spread throughout the body4. Most colorectal cancers arise from precursor lesions in the large intestine called 'adenomatous polyps'. Screening is important because it means that adenomatous polyps can be removed before they become cancerous. Screening also means that colorectal cancer can be diagnosed at an earlier stage4.
There are several methods currently used for colorectal cancer screening and there are advantages and disadvantages associated with all of them. CT colonography is a newer, less invasive method of examining the colon and rectum in which computed tomography is used to generate two- and three-dimensional images of the colon and rectum. Virtual colonoscopy has been found to be as effective at detecting adenomatous polyps as colonoscopy in an earlier study5.
References
1. GLOBOCAN 2000. Cancer Incidence, Mortality and Prevalence Worldwide (2000 estimates).
2. Scholefield JH. ABC of colorectal cancer: screening. BMJ 2000;321(7267):1004-6
3. Cancer Research UK. UK Bowel Cancer incidence statistics. Available here. Accessed on 12 September 2007
4. Smith RA, Mettlin CJ, Eyre H. 31. Cancer Screening and Early Detection. In: D. W. Kufe et al., eds. Cancer Medicine. 6 ed. Hamilton, London: BC Decker Inc, 2003
5. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349(23):2191-200
Medicsight PLC is a UK-based, research driven, leading developer of computer-aided detection (CAD) and image analysis software for the medical imaging market. The CAD software automatically highlights suspicious areas on computerised tomography (CT) scans of the colon and lung, helping radiologists to identify, measure and analyse potential disease and early indicators of disease. Medicsight's computer-aided detection (CAD) software has been validated using one of the world's largest and most population diverse databases of verified patient CT scan data. Medicsight's ColonCAD™ and LungCAD™ software products are seamlessly integrated with the advanced 3D visualisation workstations of several industry-leading imaging equipment partners.
About Computer-Aided Detection
With increasingly sophisticated radiological imaging hardware such as Multi-Detector CT scanners, radiologists are facing a growing challenge in the amount of detailed patient image data that they must review for each patient examination. Some CT scan examinations generate as many as 1000 images per patient. Review of this data by the radiologist is not only time-consuming but also prone to error due to reader fatigue. CAD software can help the reviewing radiologist by analysing the image data and automatically highlighting suspicious regions of interest for closer inspection. Without CAD software some potential abnormalities or areas of disease may be overlooked. This is critical for diagnosis and the management of patient outcomes as early detection of disease greatly increases the probability of successful treatment and a positive therapeutic outcome.
About Medicsight's CAD software
Medicsight's ColonCAD™ and LungCAD™ software use an advanced CAD algorithm to analyse CT scans of the colon and lung and automatically highlight suspicious areas that may be indicators of disease. CAD may highlight areas easily overlooked by the reviewing radiologist, such as small lesions or regions that are hidden from view behind folds in the colon or normal structures and surrounding tissue in the lung.
Both CAD products seamlessly integrate with the advanced 3D visualisation platforms of industry-leading imaging equipment partners. The integrated systems provide sophisticated image viewing capabilities, including 3D reconstructed image data, with the added advantage of demonstrating automatic CAD findings to assist clinical end users in the detection and analysis of disease. This allows clinical end users to perform either a 'second read', where CAD findings are displayed to the user after completion of an initial review of the CT scan data, or a 'concurrent read' where CAD findings are displayed during the user's initial review of the original CT scan images.
Since inception, Medicsight has developed close and lasting relationships with some of the world's foremost clinicians in product related areas. This provides the Company with a wealth of clinical expertise and dedicated clinical research to support ongoing product development. Medicsight also collaborates with a number of leading academic institutions and clinical research programmes worldwide to develop the Company's comprehensive database of population diverse verified patient CT scan data, thus allowing Medicsight's products to be validated to the highest possible standards.
About ACRIN
The American College of Radiology Imaging Network (ACRIN) is a national cancer research organization sponsored and funded by the US National Cancer Institute.
About adenomas
An adenoma (sometimes known as a polyp) is a slow-growing benign tumour. This is the most common type of early-stage tumour found in the colon and typically projects into the colon from the wall. Adenomas are routinely removed on identification because of their tendency to become malignant.
acrin/
суббота, 2 июля 2011 г.
Discovery Could Improve Understanding Of Ulcerative Colitis, Lead To New Therapies
An international team led by University of Pittsburgh School of Medicine researchers has identified genetic markers associated with risk for ulcerative colitis. The findings, which appear as an advance online publication of the journal Nature Genetics, bring researchers closer to understanding the biological pathways involved in the disease and may lead to the development of new treatments that specifically target them.
Ulcerative colitis is a chronic, relapsing disorder that causes inflammation and ulceration in the inner lining of the rectum and large intestine. The most common symptoms are diarrhea (oftentimes bloody) and abdominal pain. Ulcerative colitis and Crohn's disease, another chronic gastrointestinal inflammatory disorder, are the two major forms of inflammatory bowel disease (IBD).
"Ulcerative colitis and Crohn's disease are chronic conditions that impact the day-to-day lives of patients," said senior author of the study Richard H. Duerr, M.D., associate professor of medicine and human genetics at the University of Pittsburgh School of Medicine and Graduate School of Public Health. "IBD is most often diagnosed in the teenage years or early adulthood. While patients usually don't die from IBD, affected individuals live with its debilitating symptoms during the most productive years of their lives."
Because IBD tends to run in families, researchers have long thought that genetic factors play a role. Technology developed in recent years has enabled systematic, genome-wide searches for gene markers associated with common human diseases, and the discovery of more than 30 genetic risk factors for Crohn's disease has been one of the major success stories in this new era of research. While some genetic factors associated with Crohn's disease also predispose individuals to ulcerative colitis, markers specific for ulcerative colitis had yet to be found. To do so, researchers performed a genome-wide association study of hundreds of thousands of genetic markers using DNA samples from 1,052 individuals with ulcerative colitis and pre-exisiting data from 2,571 controls, all of European ancestry and residing in North America. Several genetic markers on chromosomes 1p36 and 12q15 showed highly significant associations with ulcerative colitis, and the association evidence was replicated in independent European ancestry samples from North America and southern Italy. Nearby genes implicated as possibly playing a role in ulcerative colitis include the ring finger protein 186 (RNF186), OTU domain containing 3 (OTUD3), and phospholipase A2, group IIE (PLA2G2E) - genes on chromosome 1p36, and the interferon, gamma (IFNG), interleukin 26 (IL26), and interleukin 22 (IL22) genes on chromosome 12q15. RNF186 and OTUD3 are members of gene families involved in protein turnover and diverse cellular processes. PLA2G2E, IFNG, IL26 and IL22 are known to play a role in inflammation and the immune response. The study also found highly suggestive associations between ulcerative colitis and genetic markers on chromosome 7q31 within or near the laminin, beta 1 (LAMB1) gene, which is a member of a gene family known to play a role in intestinal health and disease, and confirmed previously identified associations between ulcerative colitis and genetic variants in the interleukin 23 receptor (IL23R) gene on chromosome 1p31 and the major histocompatibility complex on chromosome 6p21.
"My laboratory is focused on studying the genetic basis for IBD," said Dr. Duerr. "Through genetic mapping, we and our collaborators are successfully identifying regions of the genome that contain IBD genes. The next steps are to understand the functional significance of IBD-associated genetic variants, and then to develop new treatments that specifically target biological pathways implicated by the genetic discoveries. The overall goal of this work is to improve the lives of the millions of patients worldwide that suffer from IBD."
The study's authors represent the IBD Genetics Consortium, which is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). In addition to the University of Pittsburgh, the NIDDK IBD Genetics Consortium's member institutions include Cedars-Sinai Medical Center in Los Angeles, the University of Chicago, Johns Hopkins University, Universit?© de Montr?©al and the Montreal Heart Institute, Mount Sinai Hospital in Toronto, and Yale University. Other study authors who collaborated with the NIDDK IBD Genetics Consortium to enable the study include researchers from Carnegie Mellon University, the Cleveland Clinic Foundation, The Feinstein Institute for Medical Research, and the Massachusetts General Hospital; CHUM - H??pital Saint-Luc in Montreal, The Hospital for Sick Children and Princess Margaret Hospital in Toronto, and CHAUQ - H??pital du St-Sacrement in Quebec; and the IRCCS -CSS Hospital in S. Giovanni Rotondo, Italy.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in NIH grant support, which has more than doubled since 1998. For fiscal year 2006, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center (UPMC). Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
Source: Courtney McCrimmon
University of Pittsburgh Schools of the Health Sciences
Ulcerative colitis is a chronic, relapsing disorder that causes inflammation and ulceration in the inner lining of the rectum and large intestine. The most common symptoms are diarrhea (oftentimes bloody) and abdominal pain. Ulcerative colitis and Crohn's disease, another chronic gastrointestinal inflammatory disorder, are the two major forms of inflammatory bowel disease (IBD).
"Ulcerative colitis and Crohn's disease are chronic conditions that impact the day-to-day lives of patients," said senior author of the study Richard H. Duerr, M.D., associate professor of medicine and human genetics at the University of Pittsburgh School of Medicine and Graduate School of Public Health. "IBD is most often diagnosed in the teenage years or early adulthood. While patients usually don't die from IBD, affected individuals live with its debilitating symptoms during the most productive years of their lives."
Because IBD tends to run in families, researchers have long thought that genetic factors play a role. Technology developed in recent years has enabled systematic, genome-wide searches for gene markers associated with common human diseases, and the discovery of more than 30 genetic risk factors for Crohn's disease has been one of the major success stories in this new era of research. While some genetic factors associated with Crohn's disease also predispose individuals to ulcerative colitis, markers specific for ulcerative colitis had yet to be found. To do so, researchers performed a genome-wide association study of hundreds of thousands of genetic markers using DNA samples from 1,052 individuals with ulcerative colitis and pre-exisiting data from 2,571 controls, all of European ancestry and residing in North America. Several genetic markers on chromosomes 1p36 and 12q15 showed highly significant associations with ulcerative colitis, and the association evidence was replicated in independent European ancestry samples from North America and southern Italy. Nearby genes implicated as possibly playing a role in ulcerative colitis include the ring finger protein 186 (RNF186), OTU domain containing 3 (OTUD3), and phospholipase A2, group IIE (PLA2G2E) - genes on chromosome 1p36, and the interferon, gamma (IFNG), interleukin 26 (IL26), and interleukin 22 (IL22) genes on chromosome 12q15. RNF186 and OTUD3 are members of gene families involved in protein turnover and diverse cellular processes. PLA2G2E, IFNG, IL26 and IL22 are known to play a role in inflammation and the immune response. The study also found highly suggestive associations between ulcerative colitis and genetic markers on chromosome 7q31 within or near the laminin, beta 1 (LAMB1) gene, which is a member of a gene family known to play a role in intestinal health and disease, and confirmed previously identified associations between ulcerative colitis and genetic variants in the interleukin 23 receptor (IL23R) gene on chromosome 1p31 and the major histocompatibility complex on chromosome 6p21.
"My laboratory is focused on studying the genetic basis for IBD," said Dr. Duerr. "Through genetic mapping, we and our collaborators are successfully identifying regions of the genome that contain IBD genes. The next steps are to understand the functional significance of IBD-associated genetic variants, and then to develop new treatments that specifically target biological pathways implicated by the genetic discoveries. The overall goal of this work is to improve the lives of the millions of patients worldwide that suffer from IBD."
The study's authors represent the IBD Genetics Consortium, which is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). In addition to the University of Pittsburgh, the NIDDK IBD Genetics Consortium's member institutions include Cedars-Sinai Medical Center in Los Angeles, the University of Chicago, Johns Hopkins University, Universit?© de Montr?©al and the Montreal Heart Institute, Mount Sinai Hospital in Toronto, and Yale University. Other study authors who collaborated with the NIDDK IBD Genetics Consortium to enable the study include researchers from Carnegie Mellon University, the Cleveland Clinic Foundation, The Feinstein Institute for Medical Research, and the Massachusetts General Hospital; CHUM - H??pital Saint-Luc in Montreal, The Hospital for Sick Children and Princess Margaret Hospital in Toronto, and CHAUQ - H??pital du St-Sacrement in Quebec; and the IRCCS -CSS Hospital in S. Giovanni Rotondo, Italy.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in NIH grant support, which has more than doubled since 1998. For fiscal year 2006, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center (UPMC). Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
Source: Courtney McCrimmon
University of Pittsburgh Schools of the Health Sciences
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