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PubMed · 1890756

[Ulcerative colitis and pregnancy].

K Kobayashi·T Katsumata·M Igarashi·H Mitomi·K Saigenji·N Shimada
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Abstract

The relationship between ulcerative colitis (UC) and pregnancy was studied in 83 cases (124 deliveries). The results were as follows: 1) In women with UC, there was no significant difference in fertility compared with the general population. 2) The existence of UC and treatment of UC during pregnant period had no significant adverse effects for the course of pregnancy. 3) In the 17 out of 36 pregnancies with inactive UC at the onset of pregnancy suffered relapses. Relapse rate in same patients in the pregnant period was significant higher than that in the non-pregnant period. 4) First attack of UC developing in 12 cases during pregnancies or the puerperium, the onset being commonly in the first trimester. UC developing during pregnancy was especially severe in other patients. We concluded that the relapse rate of UC is high during pregnant period, however, the course of pregnancy is not affected with UC.

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Colitis, UlcerativeFemaleHumansPregnancyPregnancy ComplicationsRecurrenceEnglish AbstractJournal Article

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BibTeXRIS

K Kobayashi, T Katsumata, M Igarashi, H Mitomi, K Saigenji, N Shimada. 1991. [Ulcerative colitis and pregnancy].. https://pubmed.ncbi.nlm.nih.gov/1890756/

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Hypothesis about mechanisms through which nicotine might exert its effect on the interdependence of inflammation and gut barrier function in ulcerative colitis.

Ulcerative colitis (UC) is characterized by impairment of the epithelial barrier and the formation of ulcer-type lesions, which result in local leaks and generalized alterations of mucosal tight junctions. Ultimately, this results in increased basal permeability. Although disruption of the epithelial barrier in the gut is a hallmark of inflammatory bowel disease and intestinal infections, it remains unclear whether barrier breakdown is an initiating event of UC or rather a consequence of an underlying inflammation, evidenced by increased production of proinflammatory cytokines. UC is less common in smokers, suggesting that the nicotine in cigarettes may ameliorate disease severity. The mechanism behind this therapeutic effect is still not fully understood, and indeed it remains unclear if nicotine is the true protective agent in cigarettes. Nicotine is metabolized in the body into a variety of metabolites and can also be degraded to form various breakdown products. It is possible these metabolites or degradation products may be the true protective or curative agents. A greater understanding of the pharmacodynamics and kinetics of nicotine in relation to the immune system and enhanced knowledge of gut permeability defects in UC are required to establish the exact protective nature of nicotine and its metabolites in UC. This review suggests possible hypotheses for the protective mechanism of nicotine in UC, highlighting the relationship between gut permeability and inflammation, and indicates where in the pathogenesis of the disease nicotine may mediate its effect.

Colitis, Ulcerative↗