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1.
Biomacromolecules ; 25(5): 3018-3032, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38648261

RESUMEN

Different cellulose nanocrystal (CNC) forms (dried vs never-dried) can lead to different degrees of CNC reassembly, the formation of nanofibril-like structures, in nanocomposite latex-based pressure-sensitive adhesive (PSA) formulations. CNC reassembly is also affected by CNC sonication and loading as well as the protocol used for CNC addition to the polymerization. In this study, carboxylated CNCs (cCNCs) were incorporated into a seeded, semibatch, 2-ethylhexyl acrylate/methyl methacrylate/styrene emulsion polymerization and cast as pressure-sensitive adhesive (PSA) films. The addition of CNCs led to a simultaneous increase in tack strength, peel strength, and shear adhesion, avoiding the typical trade-off between the adhesive and cohesive strength. Increased CNC reassembly resulted from the use of dried, redispersed, and sonicated cCNCs, along with increased cCNC loading and addition of the cCNCs at the seed stage of the polymerization. The increased degree of CNC reassembly was shown to significantly increase the shear adhesion by enhancing the elastic modulus of the PSA films.


Asunto(s)
Adhesivos , Celulosa , Látex , Nanopartículas , Celulosa/química , Adhesivos/química , Nanopartículas/química , Látex/química , Polimerizacion , Nanocompuestos/química , Presión
2.
Macromol Rapid Commun ; 43(3): e2100493, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34841604

RESUMEN

Bio-based Pickering emulsifiers are a nontoxic alternative to surfactants in emulsion formulations and heterogenous polymerizations. Recent demand for biocompatible and sustainable formulations has accelerated academic interest in polysaccharide-based nanoparticles as Pickering emulsifiers. Despite the environmental advantages, the inherent hydrophilicity of polysaccharides and their nanoparticles limits efficiency and application range. Modification of the polysaccharide surface is often required in the development of ultrastable, functional, and water-in-oil (W/O) systems. Complex surface modification calls into question the sustainability of polysaccharide-based nanoparticles and is identified as a significant barrier to commercialization. This review summarizes the use of nanocelluloses, -starches, and -chitins as Pickering emulsifiers, highlights trends and best practices in surface modification, and provides recommendations to expedite commercialization.


Asunto(s)
Nanopartículas , Emulsiones , Polimerizacion , Polisacáridos , Tensoactivos
3.
Langmuir ; 36(46): 13989-13997, 2020 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-33186049

RESUMEN

Cellulose nanocrystals (CNCs) were converted into a CO2-responsive composite nanomaterial by grafting poly(dimethylaminoethyl methacrylate) (PDMAEMA), poly(diethylaminoethyl methacrylate) (PDEAEMA), and poly(diisopropylaminoethyl methacrylate) (PDPAEMA) onto its surface using both grafting-to and grafting-from approaches. The zeta potential (ζ) of the graft-modified CNC could be reversibly switched by protonation/deprotonation of the tertiary amine groups simply by sparging with CO2 and N2, respectively. Depending on the grafting density and the molecular weight of the polymer grafts, CNC can form stable aqueous dispersions at either mildly acidic pH (under CO2) or mildly basic (under N2) conditions. Moreover, it was also determined that the CNC hydrophobicity, assessed using phase-shuttling experiments at different pH values, was also dependent on both the grafting density and molecular weight of the polymer grafts, thereby making it possible to easily tune CNC dispersibility and/or hydrophobicity.

4.
Langmuir ; 36(3): 796-809, 2020 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-31873028

RESUMEN

We report a mechanistic study of the microsuspension polymerization of styrene stabilized by cellulose nanocrystals (CNCs) in its native form as well as graft-modified with copolymers of styrene and N-3-(dimethylamino)propyl methacrylamide (DMAPMAm) or N,N-(diethylamino)ethyl methacrylate (DEAEMA). Native CNCs and graft-modified CNCs were shown to form stable styrene emulsions with an average droplet diameter of 18-20 and 5-9 µm, respectively. Initiators of widely varying water solubilities [2,2'-azobisisobutyronitrile (AIBN), 2-2'-azobis(2,4-dimethylvaleronitrile) (Vazo-52), and lauroyl peroxide (LPO)] were employed for the polymerizations. The type of initiator and the type of CNC were shown to directly affect the microsuspension polymerization kinetics, particle size, and molecular weight distribution. Using AIBN and Vazo-52, submicron latex particles were observed in the final latex in addition to the desired 3-20 µm CNC-armored microsuspension particles. The resulting latex and microsuspension polystyrene particles were studied for their CNC coverage and surface charge. We found that the presence of CNCs in the aqueous phase did not lead to Pickering emulsion polymerization by heterogeneous nucleation.

5.
Biomacromolecules ; 21(11): 4377-4378, 2020 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-33161722

RESUMEN

This special issue of Biomacromolecules highlights research from The International Polymer Colloid Group (IPCG), which was founded in 1972 as a forum for the exchange of ideas and emerging research activities for scientists and engineers from both academia and industry who study or use polymer colloids. The increasing relevance of polymeric structures with colloidal dimensions to biomacromolecules research provided the impetus for organizing this special issue. The IPCG is composed of over 120 researchers from over 20 countries who are elected to membership. Activities comprise annual symposia including a biennial International Polymer Colloid Group Research Conference and a semiannual newsletter that incorporates a summary of recent (including unpublished) research results from our members.


Asunto(s)
Coloides , Polímeros
6.
Biomacromolecules ; 21(11): 4492-4501, 2020 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-32368898

RESUMEN

Starch nanoparticles (SNP) were modified with synthetic polymers using the "grafting to" approach and nitroxide-mediated polymerization. SG1-capped poly(methyl methacrylate-co-styrene) (P(MMA-co-S)) copolymers with low dispersity and high degree of livingness were first synthesized in bulk. These macroalkoxyamines were then grafted to vinyl benzyl-functionalized SNP to obtain biosynthetic hybrids. The grafted materials, SNP-g-P(MMA-co-S), were characterized by 1H NMR, FTIR, TGA, and elemental analysis. The total amount of grafted polymer and the grafting efficiency were evaluated for different molecular weights (5870-12150 g·mol-1) of the grafted polymer, the polymer addition approach (batch or semibatch) and the initial polymer loading (2.5, 5, or 10 g polymer/g SNP). The proposed approach presented in this work to graft modify SNP allows for a precise surface modification of the nanoparticles, while permitting that the final properties of the resulting biohybrid to be tunable according to the choice of polymer grafted.


Asunto(s)
Nanopartículas , Almidón , Óxidos de Nitrógeno , Polimerizacion
7.
Macromol Rapid Commun ; 40(2): e1800326, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30040146

RESUMEN

Ring opening metathesis polymerization (ROMP) is a technique that allows the synthesis of well-defined linear polyolefins. Polymerization-induced self-assembly (PISA) involves the synthesis of amphiphilic block copolymers: a hydrophilic block is first polymerized homogeneously in solution (usually water) followed by polymerization of a second hydrophobic block, resulting in a diblock copolymer that self-assembles. In this communication, preliminary results of the development of PISA for the synthesis of amphiphilic block linear polyolefins via ROMP using a water-soluble PEGylated ruthenium alkylidene catalyst are presented. In the first step, a water-soluble modified-norbornene monomer was polymerized in water, then 1,5-cyclooctadiene was added to the system to produce amphiphilic block polyolefins. By varying the concentrations of hydrophilic versus hydrophobic monomer, stable latexes with final particles of ≈200 nm diameter were prepared.


Asunto(s)
Alcadienos/química , Técnicas de Química Sintética/métodos , Polimerizacion , Polímeros/química , Alcadienos/síntesis química , Catálisis , Interacciones Hidrofóbicas e Hidrofílicas , Microscopía Electrónica de Transmisión , Modelos Químicos , Estructura Molecular , Norbornanos/química , Polienos/síntesis química , Polienos/química , Polietilenglicoles/química , Polímeros/síntesis química , Rutenio/química , Agua/química
8.
Macromol Rapid Commun ; 40(13): e1900087, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31058385

RESUMEN

The synthesis of diblock and triblock linear polyolefins via ring opening metathesis polymerization (ROMP) in an aqueous nanoparticle dispersion is presented. The different block polyolefins are synthesized from the cyclic olefins 1,5-cyclooctadiene and norbornene (NB), using a water-soluble TEGylated ruthenium alkylidene catalyst, yielding the structures PCOD-b-PNB, PNB-b-PCOD, and PCOD-b-PNB-b-PCOD. High monomer conversion (>90%), monitored by NMR, is achieved in relatively short times (≈1 h) for the polymerization of each block. The livingness of the system, essential to obtain block copolymers, is confirmed by gel permeation chromatography. Latex particles' size during the multiple steps range between 90 and 150 nm. The results demonstrate that it is possible to obtain nanoparticle latexes from ROMP-based monomers with block copolymer architectures, creating the opportunity to copolymerize olefins bearing different functional groups for the synthesis of new materials.


Asunto(s)
Alcadienos/química , Norbornanos/química , Polímeros/síntesis química , Rutenio/química , Catálisis , Emulsiones , Estructura Molecular
9.
Macromol Rapid Commun ; 40(10): e1800834, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30663157

RESUMEN

Nitroxide-mediated polymerization (NMP) is employed to graft synthetic polymers from polysaccharides. This work demonstrates the first successful polymer grafting from starch nanoparticles (SNPs) via NMP. To graft synthetic polymers from the SNPs' surface, the SNPs are first functionalized with 4-vinylbenzyl chloride prior to reaction with BlocBuilder MA yielding a macroinitiator. Methyl methacrylate with styrene, acrylic acid, or methyl acrylate are then grafted from the SNPs. The polymerizations exhibited linear reaction kinetics, indicating that they are well controlled. Thermal gravimetric analysis and spectroscopic techniques confirmed the synthesis of the precursors materials and the success of the grafting from polymerizations. The incorporation of hydrophobic synthetic polymers on hydrophilic SNPs yields new hybrid materials that could find use in several industrial applications including paper coatings, adhesives, and paints.


Asunto(s)
Nanopartículas/química , Polímeros/síntesis química , Almidón/síntesis química , Acrilatos/química , Interacciones Hidrofóbicas e Hidrofílicas , Cinética , Peso Molecular , Polimerizacion , Polímeros/química , Almidón/química , Estireno/química
10.
Crit Rev Biotechnol ; 38(2): 199-217, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28595468

RESUMEN

The composition and structural properties of lignocellulosic biomass have significant effects on its downstream conversion to fuels, biomaterials, and building-block chemicals. Specifically, the recalcitrance to modification and compositional variability of lignocellulose make it challenging to optimize and control the conditions under which the conversion takes place. Various characterization protocols have been developed over the past 150 years to elucidate the structural properties and compositional patterns that affect the processing of lignocellulose. Early characterization techniques were developed to estimate the relative digestibility and nutritional value of plant material after ingestion by ruminants and humans alike (e.g. dietary fiber). Over the years, these empirical techniques have evolved into statistical approaches that give a broader and more informative analysis of lignocellulose for conversion processes, to the point where an entire compositional and structural analysis of lignocellulosic biomass can be completed in minutes, rather than weeks. The use of modern spectroscopy and chemometric techniques has shown promise as a rapid and cost effective alternative to traditional empirical techniques. This review serves as an overview of the compositional analysis techniques that have been developed for lignocellulosic biomass in an effort to highlight the motivation and migration towards rapid, accurate, and cost-effective data-driven chemometric methods. These rapid analysis techniques can potentially be used to optimize future biorefinery unit operations, where large quantities of lignocellulose are continually processed into products of high value.


Asunto(s)
Lignina/química , Biomasa , Técnicas de Química Analítica , Análisis Espectral
11.
Angew Chem Int Ed Engl ; 57(4): 962-966, 2018 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-29124836

RESUMEN

Ab initio emulsion polymerization of methyl methacrylate (MMA) using a water-soluble organotellurium chain transfer agent in the presence of the surfactant Brij 98 in water is reported. Polymerization proceeded under both thermal and visible light-irradiation conditions, giving poly(methyl methacrylate) (PMMA) with controlled molecular weight and low dispersity (D<1.5). Despite the formation of an opaque latex, the photoactivation of the organotellurium dormant species took place efficiently, as demonstrated by the quantitative monomer conversion and temporal control. Control of polymer particle size (PDI<0.030) was also achieved using a semi-batch monomer addition process. The PMMA polymer in the particles retained high end-group fidelity and was successfully used for the synthesis of block copolymers.

12.
Chem Soc Rev ; 45(15): 4391-436, 2016 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-27284587

RESUMEN

CO2 is an ideal trigger for switchable or stimuli-responsive materials because it is benign, inexpensive, green, abundant, and does not accumulate in the system. Many different CO2-responsive materials including polymers, latexes, solvents, solutes, gels, surfactants, and catalysts have been prepared. This review focuses on the preparation, self-assembly, and functional applications of CO2-responsive polymers. Detailed discussion is provided on the synthesis of CO2-responsive polymers, in particular using reversible deactivation radical polymerization (RDRP), formerly known as controlled/living radical polymerization (CLRP), a powerful technique for the preparation of well-defined (co)polymers with precise control over molecular weight distribution, chain-end functional groups, and polymer architectural design. Self-assembly in aqueous dispersed media is highlighted as well as emerging potential applications.

13.
Environ Sci Technol ; 50(14): 7896-903, 2016 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-27314988

RESUMEN

There is a pressing need to develop efficient and sustainable approaches to harvesting microalgae for biofuel production and water treatment. CO2-switchable crystalline nanocellulose (CNC) modified with 1-(3-aminopropyl)imidazole (APIm) is proposed as a reversible coagulant for harvesting microalgae. Compared to native CNC, the positively charged APIm-modified CNC, which dispersed well in carbonated water, showed appreciable electrostatic interaction with negatively charged Chlorella vulgaris upon CO2-treatment. The gelation between the modified CNC, triggered by subsequent air sparging, can also enmesh adjacent microalgae and/or microalgae-modified CNC aggregates, thereby further enhancing harvesting efficiencies. Moreover, the surface charges and dispersion/gelation of APIm-modified CNC could be reversibly adjusted by alternatively sparging CO2/air. This CO2-switchability would make the reusability of redispersed CNC for further harvesting possible. After harvesting, the supernatant following sedimentation can be reused for microalgal cultivation without detrimental effects on cell growth. The use of this approach for harvesting microalgae presents an advantage to other current methods available because all materials involved, including the cellulose, CO2, and air, are natural and biocompatible without adverse effects on the downstream processing for biofuel production.


Asunto(s)
Biocombustibles , Microalgas , Biomasa , Chlorella vulgaris , Agua
14.
Biomacromolecules ; 16(7): 2040-8, 2015 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-26068280

RESUMEN

Alginate-based amphiphilic graft copolymers were synthesized by single electron transfer living radical polymerization (SET-LRP), forming stable micelles during polymerization induced self-assembly (PISA). First, alginate macroinitiator was prepared by partial depolymerization of native alginate, solubility modification and attachment of initiator. Depolymerized low molecular weight alginate (∼12 000 g/mol) was modified with tetrabutylammonium, enabling miscibility in anhydrous organic solvents, followed by initiator attachment via esterification yielding a macroinitiator with a degree of substitution of 0.02, or 1-2 initiator groups per alginate chain. Then, methyl methacrylate was polymerized from the alginate macroinitiator in mixtures of water and methanol, forming poly(methyl methacrylate) grafts, prior to self-assembly, of ∼75 000 g/mol and polydispersity of 1.2. PISA of the amphiphilic graft-copolymer resulted in the formation of micelles with diameters of 50-300 nm characterized by light scattering and electron microscopy. As the first reported case of LRP from alginate, this work introduces a synthetic route to a preparation of alginate-based hybrid polymers with a precise macromolecular architecture and desired functionalities. The intended application is the preparation of micelles for drug delivery; however, LRP from alginate can also be applied in the field of biomaterials to the improvement of alginate-based hydrogel systems such as nano- and microhydrogel particles, islet encapsulation materials, hydrogel implants, and topical applications. Such modified alginates can also improve the function and application of native alginates in food and agricultural applications.


Asunto(s)
Alginatos/química , Materiales Biocompatibles/síntesis química , Metilmetacrilatos/síntesis química , Materiales Biocompatibles/química , Sistemas de Liberación de Medicamentos , Sustancias Macromoleculares/síntesis química , Sustancias Macromoleculares/química , Metilmetacrilatos/química , Micelas , Estructura Molecular
15.
Chemistry ; 19(18): 5595-601, 2013 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-23463681

RESUMEN

We have developed a new benign means of reversibly breaking emulsions and latexes by using "switchable water", an aqueous solution of switchable ionic strength. The conventional surfactant sodium dodecyl sulfate (SDS) is not normally stimuli-responsive when CO2 is used as the stimulus but becomes CO2 -responsive or "switchable" in the presence of a switchable water additive. In particular, changes in the air/water surface tension and oil/water interfacial tension can be triggered by addition and removal of CO2 . A switchable water additive, N,N-dimethylethanolamine (DMEA), was found to be an effective and efficient additive for the reversible reduction of interfacial tension and can lower the tension of the dodecane/water interface in the presence of SDS surfactant to ultra-low values at very low additive concentrations. Switchable water was successfully used to reversibly break an emulsion containing SDS as surfactant, and dodecane as organic liquid. Also, the addition of CO2 and switchable water can result in aggregation of polystyrene (PS) latexes; the later removal of CO2 neutralizes the DMEA and decreases the ionic strength allowing for the aggregated PS latex to be redispersed and recovered in its original state.

16.
Chem Commun (Camb) ; 59(89): 13272-13288, 2023 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-37872815

RESUMEN

The development and design of CO2-switchable colloidal particles is described. A presentation of the principles of CO2 switching, especially as they apply to colloids, is followed by recent progress in the preparation of several types of colloidal particles (polymer nanoparticles, metal-organic frameworks (MOFs), quantum dots, graphene, cellulose nanocrystals, carbon nanotubes) for various applications (Pickering stabilizers, catalysts, latexes), and our perspective on future opportunities.

17.
ACS Omega ; 8(51): 49259-49269, 2023 Dec 26.
Artículo en Inglés | MEDLINE | ID: mdl-38162778

RESUMEN

A key challenge in the development of forward osmosis (FO) technology is to identify a suitable draw solute that can generate a large osmotic pressure with favorable water flux while being easy to recover after the FO process with a minimum of energy expenditure. While the CO2- and thermo-responsive linear poly(N,N-dimethylallylamine) polymer (l-PDMAAm) has been reported as a promising draw agent for forward osmosis desalination, the draw solutions sufficiently concentrated to have high osmotic pressure were too viscous to be usable in industrial operations. We now compare the viscosities and osmotic pressures of solutions of these polymers at low and high molecular weights and with/without branching. The best combination of high osmotic pressures with low viscosity can be obtained by using low molecular weights rather than branching. Aqueous solutions of the synthesized polymer showed a high osmotic pressure of 170 bar under CO2 (πCO2) at 50 wt% loading, generating a high water flux against NaCl feed solutions in the FO process. Under air, however, the same polymer showed a low osmotic pressure and a cloud point between 26 and 33 °C (depending on concentration), which facilitates the recovery of the polymer after it has been used as a draw agent in the FO process upon removal of CO2 from the system.

18.
Macromol Rapid Commun ; 32(7): 604-9, 2011 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-21438060

RESUMEN

The use of copper tubing as both the reactor and as a catalyst source is demonstrated for continuous controlled radical polymerization of methyl acrylate at ambient temperature and at low solvent content of 30%. The high surface area provided by the copper walls mediates the reaction via the single electron transfer-living radical polymerization (SET-LRP) mechanism. The polymerizations proceeded quickly, reaching 67% conversion at a residence time of 16 min. Ligand concentration could also be reduced without a sharp drop in polymerization rate, demonstrating the potential for decreased raw material and post-process purification costs. Chain extension experiments conducted using synthesized polymer showed high livingness. The combination of living polymer produced at high polymerization rates at ambient temperature and low volatile organic solvent content demonstrate the potential of a copper reactor for scale up of SET-LRP.


Asunto(s)
Acrilatos/química , Cobre/química , Catálisis , Radicales Libres/química , Polimerizacion , Temperatura
19.
Am J Physiol Gastrointest Liver Physiol ; 299(2): G457-66, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20489045

RESUMEN

Fibroblasts represent the key cell type in fibrostenosing Crohn's disease (FCD) pathogenesis. S100A4 is an EF-hand calcium-binding protein family member, implicated in epithelial-mesenchymal transition and as a marker of activated T lymphocytes and fibroblasts in chronic tissue remodeling. The aim of this study was to examine the expression profile of S100A4 in the resected ileum of patients with FCD. Mucosa, seromuscular explants, and transmural biopsies were harvested from diseased and proximal, macroscopically normal margins of ileocecal resections from patients with FCD. Samples were processed for histochemistry, immunohistochemistry, real-time RT-PCR, Western blotting, and transmission electron microscopy. Primary explant cultures of seromuscular fibroblasts were exposed to transforming growth factor (TGF)-beta1 (1 ng/ml), and S100A4 expression and scratch wound-healing activity were assessed at 24 h. CCD-18Co fibroblasts were transfected with S100A4 small interfering RNA, treated with TGF-beta1 (1 ng/ml) for 30 min or 24 h, and then assessed for S100A4 and Smad3 expression and scratch wound-healing activity. S100A4 expression was increased in stricture mucosa, in the lamina propria, and in CD3-positive intraepithelial CD3-positive T lymphocytes. Fibroblastic S100A4 staining was observed in seromuscular scar tissue. Stricture fibroblast explant culture showed significant upregulation of S100A4 expression. TGF-beta1 increased S100A4 expression in cultured ileal fibroblasts. In CCD-18Co fibroblasts, S100A4 small interfering RNA inhibited scratch wound healing and modestly inhibited Smad3 activation. S100A4 expression is increased in fibroblasts, as well as immune cells, in Crohn's disease stricture and induced by TGF-beta1. Results from knockdown experiments indicate a potential role for S100A4 in mediating intestinal fibroblast migration.


Asunto(s)
Enfermedad de Crohn/fisiopatología , Fibroblastos/metabolismo , Íleon/fisiopatología , Proteínas S100/metabolismo , Movimiento Celular , Proliferación Celular , Células Cultivadas , Colágeno/metabolismo , Constricción Patológica , Enfermedad de Crohn/patología , Femenino , Fibroblastos/efectos de los fármacos , Fibrosis , Humanos , Íleon/patología , Mucosa Intestinal/ultraestructura , Masculino , ARN Mensajero/metabolismo , Proteína de Unión al Calcio S100A4 , Proteínas S100/genética , Proteína smad3/metabolismo , Uniones Estrechas/ultraestructura , Distribución Tisular , Factor de Crecimiento Transformador beta1/farmacología , Regulación hacia Arriba , Adulto Joven
20.
World J Surg ; 34(7): 1615-26, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20195604

RESUMEN

BACKGROUND: A pressing need exists to identify factors that predispose to recurrence after terminal ileal resection for Crohn's disease (CD) and to determine effective prophylactic strategies. This review presents an up-to-date summary of the literature in the field and points to a role for bacterial overproliferation in recurrence. METHODS: The literature (Medline, Embase, and the Cochrane Library, 1971-2009) on ileal CD and postoperative recurrence was searched, and 528 relevant articles were identified and reviewed. RESULTS: Smoking is a key independent risk factor for recurrence. NOD2/CARD15 polymorphisms and penetrating phenotype are associated with aggressive disease and higher reoperation rates. Age at diagnosis, disease duration, gender, and family history are inconsistent predictors of recurrence. Prophylactic 5-aminosalicylic acid therapy and nitromidazole antibiotics are beneficial. Combination therapies with immunosuppressants are also effective. Anti-TNFalpha-based regimens show benefit but the evidence base is small. Corticosteroid, interleukin-10, and probiotic therapies are not effective. Wider, stapled anastomotic configurations are associated with reduced recurrence rates. Strictureplasty and laparoscopic approaches have similar long-term recurrence rates to open resection techniques. Length of resection and presence of microscopic disease at resection margins do not influence recurrence. A lack of consensus exists regarding whether the presence of granulomas or plexitis affects outcome. CONCLUSIONS: Current evidence points to defects in mucosal immunity and intestinal dysbiosis of either innate (NOD2/CARD15) or induced (smoking) origin in postoperative CD recurrence. Prophylactic strategies should aim to limit dysbiosis (antibiotics, side-to-side anastomoses) or prevent downstream chronic inflammatory sequelae (anti-inflammatory, immunosuppressive, and immunomodulatory therapy).


Asunto(s)
Enfermedad de Crohn/epidemiología , Íleon/microbiología , Fumar/epidemiología , Enfermedad de Crohn/genética , Enfermedad de Crohn/microbiología , Enfermedad de Crohn/patología , Enfermedad de Crohn/cirugía , Mutación del Sistema de Lectura , Predisposición Genética a la Enfermedad/genética , Homeostasis , Humanos , Ileítis/epidemiología , Ileítis/genética , Ileítis/patología , Ileítis/cirugía , Íleon/patología , Laparoscopía , Estilo de Vida , Proteína Adaptadora de Señalización NOD2/genética , Factores de Riesgo , Prevención Secundaria
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