Tissue markers may predict treatment response to antitumor necrosis factor-α agents in children with Crohn's disease.

OBJECTIVES: Patients with moderate-severe Crohn's disease (CD) who are treated with antitumor necrosis factor alpha (TNF-α) agents may be subjected to primary nonresponse or partial response. We aimed to identify tissue markers that may predict response to these agents. METHODS: Pediatric patients (6-18 years) with either ileal or ileo-colonic CD who were treated with anti-TNF-α were stratified into three different groups based on their overall response to therapy at the end of induction including clinical and laboratory parameters (group 1-full responders [FR], group 2-partial responders [PR], group 3-nonresponders [NR]). Seven tissue markers (fibronectin, interleukin [IL]-23R, IL-23, TNF-α, collagen-III, IL-13R, and hypoxia-inducible factors [HIF]-1α) were evaluated. Immunofluorescence (IF) analyses were performed on biopsies from the terminal ileum, which were retrieved up to 6 months before treatment initiation. RESULTS: Twenty-six CD patients (16 [61.5%] males; age 13.9 ± 2.9 years), including 8 (30.8%) with ileal disease and 18 (69.2%) with ileo-colonic disease, were enrolled. Terminal ileum biopsies from nine patients from group 1, nine from group 2, and eight from group 3 were evaluated. Three antibodies were found to be significantly different between NR and FR groups; Collagen III and fibronectin stains were significantly more prominent in NR patients, while TNF-α stain was significantly more pronounced in FR, p < 0.05 for each. PR could not have been predicted with neither of markers. CONCLUSIONS: Decreased tissue IF intensity of fibronectin and collagen III and increased intensity of TNF-α may predict response to anti-TNF-α treatment.

[Plasma fibronectin in patients during toxic goiter surgery and early postoperative period]. / Vmist fibronektynu u plazmi khvorykh na toksychnyi zob pid chas khirurhichnoho likuvannia ta u rann'omu pisliaoperatsiinomu periodi.

In 63 patients with toxic goiter the fibrinonectin content in plasma and its cryoprecipitate activity (CPA) were studied during surgical treatment conduction. There were revealed lowering of its level and CPA with subsequent lowering of this indexes in postoperative period. Application of uni-group heparinized freshly frozen plasma in therapeutic complex was proposed for hypofibronectinemia correction and for reduction of postoperative thyreotoxicosis severity.

Prevention of peritoneal adhesion formation by fibrin sealant. An experimental study in rats.

The preventive effect of rat and human fibrin sealing on intra-abdominal adhesion formation was investigated in 40 rats. Intraperitoneal adhesion formation was induced by excision of 1 X 3 cm of the peritoneal parietalmuscular layer, subsequently closed by interrupted 3-0 silk sutures. A total of 80 defects were allocated to one of four treatments: 1) the defect was covered with human fibrin sealant with the aid of a syringe. 2) the defect was covered with rat fibrin sealant with the aid of a syringe. 3) the defect was covered with human fibrin sealant with the aid of a spray. 4) the defect was not covered (control group). Assessment of the adhesion formation one week postoperatively showed that the median length of adhesions in defects covered with fibrin sealant applied by a syringe (10.5 mm) or by spray (14 mm) was less than that of the control group (25 mm) to a significantly high degree (P less than 0.001). It is concluded that fibrin sealant prevents intraperitoneal adhesion formation in the present rat model.

IGEGAM: Efecto en el tratamiento de la Uveítis anterior aguda / IGEGAM: Effect on the treatment of acute anrterior uveitis

Se realizaron estudios diagnósticos e inmunológicos a 15 pacientes con uveitis anterior aguda, a quienes se les indicó tratamiento con IGEGAM, ganmaglobulina enriquecida en IgA e IgM de producción nacional, y se obvió el tratamiento convencional. Se logró una reducción de la enfermedad en sólo 2 semanas de crisis de agudización durante 48 meses

Regeneración tisular guiada en periodoncia. Segunda parte: acondicionadores radiculares / Guided tissue regeneration in periodontics. Second part: root conditioning

El tratamiento de la enfermedad periodontal por los métodos tradicionales, da como resultado una cicatrización por medio de adherencia larga. La meta de la terapia periodontal es regenerar los tejidos de soporte perdidos por el proceso de la enfermedad periodontal inflamatoria. Se han hecho esfuerzos por lograr esta meta usando barreras físicas, reabsorbibles y no reabsorbibles, para impedir la migración epitelial y tratando la superficie radicular con varios agentes: acondicionadores radiculares y factores de crecimiento. Las investigaciones recientes se han enfocado a la regeneración del periodonto, intentando definir los factores involucrados en la formación de nueva inserción de tejido conectivo a la superficie radicular denudada por la enfermedad periodontal. Después de la adhesión celular al sustrato, uno de los eventos biológicos involucrados en la regeneración tisular es la migración celular dirigida específicamente o quimiotaxis, la cual es la característica principal de muchos procesos biológicos en salud y enfermedad. Esos eventos celulares son influenciados y regulados por factores de crecimiento. Para entender el papel regulador de estos factores en la cicatrización periodontal, es importante caracterizar su influencia involucrada en los eventos celulares críticos en el proceso de cicatrización. Los factores de crecimiento estudiados y que han demostrado repetidamente su papel en estos procesos de cicatrización son: el factor de crecimiento beta transformante, el derivado de las plaquetas, el similar a la insulina y el básico del fibroblasto. También son importantes como acondicionadores radiculares las siguientes sustancias: la tetraciclina, el ácido cítrico, la fibronectina y la laminina