Clinical Aspects and Treatments for Pediatric Inflammatory Bowel Diseases / 대한소아소화기영양학회지

The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide, especially in the developing countries. It differs from adult disease in clinical manifestations, especially with regard to genetic predisposition in monogenic IBD. Pediatric disease also have a tendency to show more aggressive inflammation and greater extent of lesion. Newer drugs such as anti-tumor necrosis factor α have been known to make a difference in treating pediatric IBD. Recent studies suggested that the patients with high risk factors might have some benefits from earlier use of biologics. To achieve treatment goals such as relieving symptoms, optimizing growth, and improving quality of life while minimizing drug toxicity, more research is needed to develop tools for risk stratification in the use of biologics for pediatric IBD.

Meta analysis of infection risks of anti-TNF-αtreatment in rheumatoid arthritis / 中南大学学报(医学版)

Objective:To systematically evaluate the risks of anti-TNF-αtreatment-associated infection, severe infection and tuberculosis in rheumatoid arthritis (RA) patients, and to reduce the infection incidences associated with anti-TNF-αtherapy. Methods:We used Meta analysis to systematically review randomized controlled trials on anti-TNF-αtreatment associated risks of infecion, severe infection and tuberculosis in AR patients.Results:Although no statistically significant differences were detected in TB risk between anit-TNF-αtreatment and the control group (0.5%vs 0.07%;P=0.27, OR=1.85, 95%CI:0.62-5.52), there still existed a clinically obvious elevation of TB risk in monoclonal anti-TNF-αtreatment, which was illustrated by the results that no TB case was reported in the etanercept group, but 11 TBs in 2050 infliximab-treated cases, and 3 TBs in 722 adalimumab-treated cases. The total infection and severe infection risks were also signiifcantly higher in patients receiving anti-TNF-αtreatment (P0.05), while both kinds of monoclonal antibodies of TNF-αblockers showed a signiifcantly elevated infection or severe infection risks (P<0.05). High doses of anti-TNF-αtreatment were associated with statistically increased risks of severe infection (6.0%vs 2.8%, P=0.04, OR=1.68, 95%CI:1.02-2.78). Conclusion:The TB risk of anti-TNF-αtreatment deserves close attention, especially in places with high rate of BCG vaccination and MTb infection. Monoclonal anti-TNF-αtreatment brings higher risks of infection and severe infection than soluble TNF-αreceptor.

Intratracheal anti-tumor necrosis factor-α antibody effect on ultra-structure of lung after cardiopulmonary bypass / 中国综合临床

Objective To study the effect of intratracheal anti-tumor necrosis factor-α antibody(TNF-αAb)on ultra-structure of lung after cardiopulmonary bypass(CPB).Method 28 healthy rabbits were selected and randomly evenly divided into four groups:I group only received open chest operation;Ⅱ-Ⅳ groups underwent CPB.In the IV group,rabbit TNF-α Ab (2400 ps/kg)Was dropped into the intracheal tube before operation and just after releasing the aortic clamp.Saline was given to the Ⅲ group by the same way.Water volume,TNF-α mRNA,TNF-α protein,apoptosis and pathomorphological changes were measured in the lung tissues.Results TNF-α Ab can re-duce releasing of TNF-α.It could also reduce the occurrence of apeptosis and attenuate pathomorphological changes in the lung tissue.Conclusion Intratracheal TNF-α Ab markedly lessenes the injury of nltrastructure of lung after CPB.