RESUMO
Background: The incidence of inflammatory bowel disease (IBD) is increasing yearly, some of the IBD patients have extraintestinal manifestations (EIM), and EIM has impact on the treatment of IBD. Aims: To summarize the clinical characteristics of IBD patients associated with EIM, and evaluate the therapeutic effect of infliximab (IFX). Methods: The clinical data of IBD patients associated with EIM from January 2010 to December 2020 at the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed, and the therapeutic effect of IFX was investigated. Results: In 811 patients with IBD, 50 (6.17%) patients had EIM. The commonly seen EIM was arthritis (78.00%) and erythema nodosum (26.00%); 52.00% had one EIM; 68.42% of UC patients with EIM involved E3, and 50.00% of CD patients with EIM involved L3. A total of 21 patients received IFX treatment, 2 weeks after medication, HB and ALB significantly increased, while ESR, CRP and PLT significantly decreased. Twenty⁃two weeks after medication, 83.33% of UC patients turned mild, and 70.00% of CD patients entered the remission phase. After the use of IFX, the first disappearance time of arthritis was significantly decreased when compared with those without using IFX (2.50 days vs. 10.50 days, P<0.05). The median time for the first disappearance of arthritis in patients with elevated CRP was significantly decreased than in patients with normal CRP (3.00 days vs. 9.00 days, P<0.05). Conclusions: Arthritis and erythema nodosum are common EMI in patients with IBD, and the treatment with IFX can significantly shorten the time of the first disappearance of some EIM.
RESUMO
Intestinal disorders often co-occur with inflammation and dysmotility. However, drugs which simultaneously improve intestinal inflammation and co-occurring dysmotility are rarely reported. Atractylodin, a widely used herbal medicine, is used to treat digestive disorders. The present study was designed to characterize the effects of atractylodin on amelioration of both jejunal inflammation and the co-occurring dysmotility in both constipation-prominent (CP) and diarrhea-prominent (DP) rats. The results indicated that atractylodin reduced proinflammatory cytokines TNF-α, IL-1β, and IL-6 in the plasma and inhibited the expression of inflammatory mediators iNOS and NF-kappa B in jejunal segments in both CP and DP rats. The results indicated that atractylodin exerted stimulatory effects and inhibitory effects on the contractility of jejunal segments isolated from CP and DP rats respectively, showing a contractile-state-dependent regulation. Atractylodin-induced contractile-state-dependent regulation was also observed by using rat jejunal segments in low and high contractile states respectively (5 pairs of low/high contractile states). Atractylodin up-regulated the decreased phosphorylation of 20 kDa myosin light chain, protein contents of myosin light chain kinase (MLCK), and MLCK mRNA expression in jejunal segments of CP rats and down-regulated those increased parameters in DP rats. Taken together, atractylodin alleviated rat jejunal inflammation and exerted contractile-state-dependent regulation on the contractility of jejunal segments isolated from CP and DP rats respectively, suggesting the potential clinical implication for ameliorating intestinal inflammation and co-occurring dysmotility.