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PubMed1987

Time relationships between cessation of smoking and onset of ulcerative colitis.

From 5 centres 154 patients with ulcerative colitis and a history of smoking completed a questionnaire about the temporal relationship between diagnosis of colitis and cessation of smoking. One hundred and thirty-eight of these were ex-smokers and 107 (69.5%) had stopped smoking before the diagnosis of colitis was made. Fifty-six patients (52%) developed colitis within 3 years of stopping smoking. The findings suggest that smoking exerts protective effect against the development of ulcerative colitis.

Adolescent↗
PubMed1994

Novel genetic association between ulcerative colitis and the anti-inflammatory cytokine interleukin-1 receptor antagonist.

BACKGROUND/AIMS: Ulcerative colitis and Crohn's disease have well-recognized familial tendencies, but the genetic basis of this clinical observation remains unknown. The cytokine interleukin-1 receptor antagonist is a potent anti-inflammatory protein that can prevent immune-mediated bowel inflammation in animals. We have previously characterized a polymorphism within the gene for this cytokine and others in the genes for the proinflammatory cytokines interleukin 1 alpha, interleukin 1 beta, and tumor necrosis factor alpha. The aim of this study was to determine whether inflammatory bowel disease was associated with particular alleles of these polymorphic cytokine genes. METHODS: The allelic frequencies of these polymorphic cytokine genes were determined in patients with ulcerative colitis (n = 113), Crohn's disease (n = 78), and healthy controls (n = 261). RESULTS: Allele 2 of interleukin-1 receptor antagonist was significantly over-represented in the ulcerative colitis patients: 35% versus 24% in controls (P = 0.007). Carriage of at least one copy of this allele gave an odds ratio of 2.0 for ulcerative colitis compared with controls. This association with allele 2 of interleukin 1 receptor antagonist was greatest in patients with total colitis and was not seen in Crohn's disease. There were no associations between UC and any of the other cytokine genes examined. CONCLUSIONS: This observation provides evidence that interleukin-1 receptor antagonist may have a role in determining the genetic susceptibility to and pathogenesis of ulcerative colitis.

Adult↗
PubMed1996

The topical treatment of distal ulcerative colitis.

In the absence of a definitively curative medical treatment of distal ulcerative colitis, the major objective of drug therapy is to optimize the quality of life by rapidly suppressing the symptoms of inflammation, without introducing major side effects. Conventional steroids administered topically decrease inflammation in about two-thirds of patients with active distal ulcerative colitis after 3-4 weeks of therapy. However, the risk of the systemic side-effects associated with their prolonged use discourages long-term treatment with these drugs. Enemas containing topically acting steroids are likely to replace conventional steroid enemas in the near future, especially in those patients who need long-term or high-dose therapy. The efficacy, safety and acceptance of rectal formulations of 5-aminosalicylic acid (5-ASA) in the short-term treatment of active ulcerative colitis are now well established. This 5-ASA enemas may be the best initial treatment when the disease is limited to the distal colon. Combination therapy of a topical corticosteroid with 5-ASA enema is a promising treatment for patients with active distal ulcerative colitis. Lignocaine, bismuth subsalicylate and short-chain fatty acids are new drugs under investigation with as yet unproven value. Better information concerning the natural history of the disease and a more careful definition of subgroups of patients may make it possible to personalize dosage, formulation and duration of the active medical treatment for patients with distal ulcerative colitis.

Administration, Topical↗