ABSTRACT
We report a case of a 16-year-old male who suffered from Crohn's disease (CD) with esophageal involvement, showing remarkable improvement with granulocyte/monocyte adsorption (GMA). The patient had been diagnosed as ileocolic CD and was treated with 5-aminosalicylate. He was admitted to our hospital with symptoms of fever, diarrhea, and odynophagia. Endoscopic examinations revealed that the exacerbation of ileocolic ulcers, and advent of ulcers in esophagus. Because of the patient's refusal to receive corticosteroids, immunomodulators, or biologics, he underwent GMA twice a week. After 10 sessions of GMA, he entered remission with significant decrease in clinical activity. In addition, endoscopic examinations showed remarkable improvement of ileocolic ulcers and disappearance of esophageal lesions. No adverse events were observed. GMA could be effective for manifestations of CD in gastrointestinal tract other than ileum or colon.
Subject(s)
Blood Component Removal/methods , Crohn Disease/pathology , Crohn Disease/therapy , Esophagus/pathology , Adolescent , Adsorption , Esophageal Diseases/pathology , Esophageal Diseases/therapy , Granulocytes/pathology , Humans , Male , Monocytes/pathology , Mucous Membrane/pathology , Treatment Outcome , Ulcer/pathology , Ulcer/therapyABSTRACT
The effects of cigarette smoke extract on radical formation were examined in reaction mixtures containing 13-hydroperoxide octadecadienoic acid (13-HPODE), FeCl3, cigarette smoke extract, ethylenediaminetetraacetic acid (EDTA), alpha-(4-pyridyl-1-oxide)-N-tert-butylnitrone (4-POBN), and phosphate buffer (pH 7.4). Cigarette smoke extract enhanced the formation of both 7-carboxyheptyl and pentyl radicals in the reaction. Ferric ions were reduced in the reaction mixture, suggesting that cigarette smoke extract enhances the formation of 7-carboxyheptyl and pentyl radicals by reducing ferric irons. Although there is a large body of evidence supporting the involvement of radicals such as the semiquinone radical, hydroxyl radical, superoxide radical, nitric oxide radicals in smoking-related diseases, the enhancement by cigarette smoke of lipid-derived radical formation, which we first report here, may be one of the other causes of smoking-related diseases.