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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three aspects of immunological function were studied in patients with Crohn's disease and ulcerative colitis (inflammatory bowel disease): atopic status and serum IgE levels; serum concentration of C-reactive protein; and C3 activation. The incidence of atopy, assessed by prick testing with common allergens, did not differ in patients with inflammatory bowel disease from healthy controls. 12 of 39 patients with Crohn's disease and 5 of 20 with ulcerative colitis, among whom were some non-atopic subjects, had elevated serum levels of IgE. Serum levels of C-reactive protein in patients were significantly greater than normal, even in those in whom the disease was clinically quiescent. Symptomatic patients with Crohn's disease had significantly higher levels than similar patients with ulcerative colitis and in Crohn's disease the levels correlated well with an overall assessment of severity and disease activity. Although conversion of C3 was detected in fresh serum samples from inflammatory bowel disease patients and not controls, only minimal traces were present in just 7 of 89 samples of EDTA--plasma from 47 patients; this finding did not correlate with disease activity. However, there were low titres of immunoconglutinin in the sera of some patients, but not in controls, suggesting that complement activation may be occurring in vivo.
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PMID:Immunological studies in inflammatory bowel disease. 34 25

Increased serum concentrations of acute-phase proteins can be found in active inflammatory bowel disease. Because interleukin 6 (IL-6) is one of the main mediators of acute-phase protein synthesis by the liver, the serum concentrations of IL-6 and the acute-phase proteins C-reactive protein, alpha 1-antitrypsin, and alpha 1-acid glycoprotein were determined in 70 patients with Crohn's disease (CD) and 23 patients with ulcerative colitis (UC). Disease activities were determined by established clinical activity indices. Serum IL-6 concentrations were significantly (P less than 0.005) increased in patients with CD (mean +/- SEM, 6.8 +/- 0.9 U/mL) compared with patients with UC (mean, less than 4 U/mL) and healthy controls (mean, less than 4 U/mL). Of patients with CD, 68.5% had serum IL-6 concentrations of greater than or equal to 4 U/mL, compared with 21.7% of patients with UC and 0% of healthy controls. There was a tendency toward higher serum IL-6 concentrations in patients with active CD than in patients with inactive disease. However, these differences were not statistically significant. There was no correlation between IL-6 serum concentrations and clinical activity indices, possibly because of the short circulatory lifetime and rapid hepatic clearance of IL-6 from the portal venous blood. In contrast to serum IL-6, acute-phase proteins, which have a longer circulatory lifetime, were significantly correlated with clinical activity indices. Only the follow-up of individual patients with initially highly active disease showed a further increase in IL-6 levels during acute exacerbations of the inflammatory process. The results show that most patients with even moderately active CD have significantly increased serum concentrations of IL-6, most probably reflecting a continuous stimulation of IL-6-producing cells.
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PMID:Evidence for continuous stimulation of interleukin-6 production in Crohn's disease. 149 21

In a prospective study we compared the usefulness of various laboratory tests (albumin, alpha-1-proteinase inhibitor (A1PI), cholinesterase (CHE), C-reactive protein, erythrocyte sedimentation rate, hematocrit) and activity indices (CDAI, VHAI) in relation to the disease activity by endoscopic criteria. Except for hematocrit highly significant differences (p less than 0.0005) of the mean values of all test results were found for patients without or with slight mucosal lesions compared with patients with severe inflammation of the mucosa. Further analysis of the data indicates the highest test efficiency (84%), sensitivity (80%), and specificity (88.6%) for CHE. CHE showed good correlations to all other tests; the highest correlation was found between CHE and VHAI (r = -0.78). We suggest that a suppression of CHE synthesis mediated by endotoxins and cytokines rather than an increased intestinal loss explains the decreased CHE in severe Crohn's disease. It is concluded from the data that CHE is a useful test to assess the inflammatory activity of Crohn's disease.
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PMID:Evaluation of different laboratory tests and activity indices reflecting the inflammatory activity of Crohn's disease. 141 Dec 85

In 40 patients with Crohn's disease the subsequent parameters were determined in relation to the endoscopic features (group A: no or slight activity respectively [n = 26]; group B: severe inflammation of the mucosa [n = 14]; group C: patients of group B after four-weeks treatment): Crohn's disease activity index (CDAI), van Hees activity index (VHAI), C-reactive protein (CRP), ESR (erythrocytic sedimentation rate), albumin, hematocrit, platelets, alpha-1-antitrypsin (A1AT), antithrombin III, fibrinogen, clotting factors V and VIII. The hemostaseological tests were compared to the data of 16 healthy controls. The results showed significant differences regarding the mean values of CRP, ESR, albumin, CDAI, VHAI, platelets and A1AT between group A, B and C. No influence of localization or duration of the disease, age or sex could be shown by multivariate analysis. The highest test efficacy to discriminate between patients of group A and B was determined for VHAI (81.1%) and alpha-1-antitrypsin (78.4%). CDAI, platelet count, ESR (each 75.7%), CRP (70.3%) and hematocrit were less efficient. Levels of fibrinogen (59.4%) and clotting factors V (59.4%) and VIII (64.8%) were much less important. In conclusion A1AT and platelet count should be regarded as helpful tests in the evaluation of the inflammatory activity in Crohn's disease.
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PMID:[Value of alpha-1-antitrypsin and thrombocytes in the assessment of inflammatory activity in Crohn disease]. 154 82

One hundred and sixty-six Japanese patients with Crohn's disease were subjected to a study of the correlation of disease type and severity to clinical findings including laboratory data, x-ray findings, and complications at the time of diagnosis. Those who had undergone bowel resection and who had localized lesions in the appendix and anorectum, or minimal lesions were not included in this study. According to the site of lesions, the patients were divided into three groups; small intestinal type (n = 81), ileocolic type (n = 61), colonic type (n = 24). In addition, based on the severity of inflammation, the patients were divided into another three groups; those who showed C-reactive protein (CRP) greater than or equal to 4+ and erythrocyte sedimentation rate (ESR) greater than or equal to 40 mm/hour (severe inflammation group, n = 31), those who showed CRP less than or equal to 2+ and ESR less than or equal to 15 mm/hour (mild inflammation group, n = 29), and those who belonged to between the severe and mild inflammation groups (moderate inflammation group, n = 106). The clinical findings at the time of diagnosis were compared between the severe and mild groups to determine the factors contributing to the severity of inflammation, using an univariate analysis and a multivariate one. The results were as follows: 1) Eighty-one patients had isolated small intestinal type of disease (48.8%), 61 ileocolic type (36.7%), and 24 colonic type alone (14.5%). 2) The ratio of male to female was 2.07. The average age at the time of onset was 21.1 years, and the age at diagnosis 23.6 years. 3) The average ages at onset and at the time of diagnosis were younger in patients with ileocolic type than in those with small intestinal or colonic type alone. 4) Patients with colonic type of disease had a higher incidence of bloody stool, diarrhea, and anemia than did those with small intestinal or ileocolic type of disease, while weight loss was most frequently observed in those with ileocolic type. 5) Crohn's disease activity index (CDAI) was the highest in patients with colonic involvement, and those with small intestinal disease had significantly lower values of CDAI than did those with the other disease types. Similarly, both values for CRP and ESR were significantly lower in patients with small intestinal type than in those with the other disease types.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Clinical features of Crohn's disease: relationship of disease type and severity to clinical findings at the time of diagnosis in 166 cases]. 154 90

Alpha-1-proteinase inhibitor-bound elastase (EPIC) was measured in plasma and fresh stool samples from 20 patients with Crohn's disease (CD), 16 patients with ulcerative colitis (UC), and 10 controls. Median EPIC values were significantly higher than normal in active CD and UC. EPIC was virtually undetectable in the stool samples of control subjects. Median faecal EPIC in 14 patients with active CD (478 ng/ml) or 10 patients with active UC (1159 ng/ml) was significantly higher than in quiescent disease (p less than 0.05) and in control subjects (p less than 0.001 in each case). The difference in the median values between active CD and UC was not significant (p = 0.065). The median faecal EPIC levels were identical in active UC (1159 ng/ml) and patients with large-bowel CD (LBCD) (1015 ng/ml) (p = 0.9), and each was significantly higher than the value of 168 ng/ml in small-bowel CD (SBCD) (p less than 0.01 in each case). In active LBCD but not in SBCD, faecal EPIC correlated significantly with Crohn's disease activity index (R = 0.78, p less than 0.05), plasma C-reactive protein (CRP) (R = 0.9, p less than 0.01), and erythrocyte sedimentation rate (ESR) (R = 0.74, p less than 0.05). In active UC, faecal EPIC correlated significantly with a numerical disease activity index (R = 0.9, p less than 0.01) but not with plasma EPIC and CRP, ESR, and leucocyte counts. Faecal EPIC values may be a better reflection of disease activity in active UC than plasma levels of markers of inflammation.
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PMID:Faecal elastase reflects disease activity in active ulcerative colitis. 156 28

An ELISA was used to measure concentrations of soluble interleukin-2 receptor (sIL-2R) alpha chain in the sera of patients with Crohn's disease. In a group of 56 patients, serum concentrations of sIL-2R were significantly raised in patients with active disease compared with patients with inactive disease and age-matched control populations. There was a significant correlation between serum sIL-2R concentration and disease activity as assessed by the Harvey-Bradshaw index (r = +0.60; P less than 0.001) and laboratory measurements of disease activity including C-reactive protein (r = +0.79; P less than 0.001), ESR (r = +0.64; P less than 0.001) and platelet count (r = +0.533; P less than 0.001). We also found a negative correlation between sIL-2R levels and serum albumin (r = -0.66; P less than 0.001). In longitudinal studies, changes in the concentration of serum sIL-2R reflected the changes in disease activity. Soluble IL-2R, therefore, offers a new measure of disease activity in Crohn's disease with a potential advantage over other laboratory parameters currently available in that it may reflect more accurately the underlying immunopathogenic process.
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PMID:Soluble interleukin-2 receptor and disease activity in Crohn's disease. 162 35

Crohn's disease (CD) and ulcerative colitis (UC) show an intestinal activation of T cells and macrophages within the inflamed lesions. The aim of the present prospective study was to determine whether circulating interleukins (IL) represent useful markers of immune activation in vivo and to characterize their respective roles in monitoring disease activity. Serum concentrations of the soluble IL-2 receptor (sIL-2R), IL-6 and IL-1 beta were measured in 10 patients with CD and 10 patients with UC before, at day 10 and 2 years after resection of inflamed bowel segments. The data were correlated with neopterin, C-reactive protein and other standard parameters of disease activity. Preoperatively, mean sIL-2R concentration was 495 +/- 62 U/ml (mean +/- SEM; healthy controls; 210 +/- 25 U/ml; p less than 0.02) in CD and 705 +/- 120 U/ml (p less than 0.00002) in UC. The corresponding IL-6 serum concentrations were 37 +/- 6 U/ml in CD (controls: 11 +/- 0.6 U/ml; p less than 0.0036) and 33 +/- 6 U/ml (p less than 0.04) in UC. Two years postoperatively, sIL-2R was still elevated in 6 out of 9 patients in both disease groups. These patients did not differ from the remaining group with respect to disease activity. Serum IL-6, elevated in 7 patients with CD and in 6 patients with UC at day 10 postoperatively, had returned to normal in all patients by this time.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Soluble interleukin-2 receptor, interleukin-6 and interleukin-1 beta in patients with Crohn's disease and ulcerative colitis: preoperative levels and postoperative changes of serum concentrations. 163 22

Calcium dependent phospholipase A2 activity in the mixed micelles of 1-palmitoyl-2-oleoyl-phosphatidylglycerol and cholate was measured in sera of 39 patients with Crohn's disease, 40 patients with ulcerative colitis, and 40 healthy controls. The phospholipase A2 activity was significantly raised in those sera of the patients with active Crohn's disease and those with moderate and severe ulcerative colitis. The major phospholipase A2 activity derived from the sera was separated into two peaks by reverse phase high performance liquid chromatography. The phospholipase A2 active fractions were immunochemically characterised using specific antibody directed against human group II phospholipase A2 purified from rheumatoid synovial fluid. The results suggest that raised serum phospholipase A2 activity in patients with Crohn's disease and ulcerative colitis was mainly attributed to the two forms of phospholipase A2 immunochemically related to group II enzyme. In patients with Crohn's disease, serum phospholipase A2 activity decreased in parallel with clinical improvement, and correlated with serum C-reactive protein and erythrocyte sedimentation rate. The results suggest that serum phospholipase A2 activity may serve as an additional indicator of disease activity. Serum phospholipase A2 activity in patients with ulcerative colitis tends to increase in relation with endoscopic severity, and may be a more sensitive laboratory index than serum C-reactive protein and erythrocyte sedimentation rate to evaluate disease activity.
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PMID:Raised serum activity of phospholipase A2 immunochemically related to group II enzyme in inflammatory bowel disease: its correlation with disease activity of Crohn's disease and ulcerative colitis. 164 31

We studied the activity assessment of ulcerative colitis and Crohn's disease by 5 acute phase reactants: C-reactive protein (CRP), alpha 1-acid glycoprotein, alpha 1 antitrypsin, haptoglobin and fibrinogen. From a large register of patients with inflammatory bowel disease (IBD) we chose randomly 91 patients: 61 with ulcerative colitis and 30 with Crohn's disease. As a reference point in the disease activity assessment we used standard clinical indices. Statistical analysis was performed by non-parametric methods: the Kruskal-Wallis and Fisher's exact test. The disease activity assessment in patients with ulcerative colitis by the index according to Powell-Tuck indicated that the patients with active disease (N = 19) had significantly higher levels of all acute phase proteins mentioned above except fibrinogen (alpha less than 0.05 to 0.001) than patients in remission (N = 42). Analysis of the same data by Fisher's exact test indicated that there had been a probability for all the proteins measured to be higher than the normal values, particullary CRP (p less than 10(-8) and the other somewhat less. In patients with Crohn's disease, the disease activity assessment was performed by 2 indices. According to "The Crohn's Disease Activity Index" (CDAI), only alpha-1 acid glycoprotein and haptoglobin (alpha less than 0.05) were higher in patients with active disease (N = 4) than in patients with remission (N = 26).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Serum acute phase proteins for determining disease activity of ulcerative colitis and Crohn disease]. 172 73


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