IBD Flashcards
What are the risk factors for UC and and CD
smoking (mainly in CD)
diet/obesity
gut microbiome
what broadly is the pathology of IBD
interplay between host and microbes
disrupted innate immunity
uncontrolled inflammation
physical damage to epithelium and leakiness of tight junctions
what is the autoimmune mechanism in UC and CD
CD
Th-1 mediated
florid T cell expansion
defective T cell apoptosis
UC
Th-2 mediated
limited clonal expansion
normal T cell apoptosis
what are the features of CD
all gut layers affected in any part of GI tract
inflamed areas are patchy
abscesses are common
what are the features of UC
only the mucosa and submucosa are affected
the affected area is the rectum and then spreads proximally
inflamed areas are continuous
abscesses are not common
how does surgery affect treatment of UC and CD
curative in UC
not always curative in CD
what drug classes are used to treat IBD (4)
aminosalicylates
glucocorticoids
immunosuppressive agents
antibiotics
what is the MOA and side effects of aminosalicylates in IBD treatment
localised anti-inflammatory effect: inhibit IL-1, TNF-a and platelet activating factor decrease antibody secretion inhibit cytokines reduce cell migration
side effects:
abdominal pain
nausea/vomiting
diarrhoea
what is the MOA and side effects of glucocorticoids in IBD treatment
powerful anti-inflammatory and immunosuppressive effect
what is the MOA and side effects of immunosuppressive agents in IBD treatment
affects DNA synthesis and cell replication
reduces synthesis of thymidine and other purines
side effects:
toxicity
what is the MOA and side effects of antibiotics in IBD treatment
kills bacteria causing IBD and can induce and sustain remission in moderate CD
what are other treatment methods for IBD
fecal transplant
altering diet
