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Clinical significance of granuloma in Crohn's disease 被引量:5
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作者 Tamás Molnár László Tiszlavicz +2 位作者 Csaba Gyulai ferenc nagy János Lonovics 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第20期3118-3121,共4页
AIM: Granuloma is considered the hallmark of microscopic diagnosis in Crohn's disease (CD), but granulomas can be detected in only 21-60% of CD patients. The aim of this study was to evaluate the frequency of gran... AIM: Granuloma is considered the hallmark of microscopic diagnosis in Crohn's disease (CD), but granulomas can be detected in only 21-60% of CD patients. The aim of this study was to evaluate the frequency of granulomas by multiple endoscopic biopsies in patients with CD and to examine whether group of patients with or without granuloma exhibit a different clinical course. METHODS: Fifty-six patients with newly diagnosed CD were included in the study. Jejunoscopy, enteroclysis and ileo-colonoscopy were performed in all patients. At least two biopsy specimens from each examined gastrointestinal segment were examined microscopically searching granuloma. The clinical course was followed in all patients, and extraintestinal manifestations as well as details of any immunosuppressive therapy and surgical intervention were noted. RESULTS: Granuloma was found in 44.6% of the cases (25 patients). Patients with granuloma had higher activity parameters at the time of the biopsies. Extraintestinal manifestations were observed and surgical interventions were performed more often in the granuloma group. The need of immunosuppressive therapy was significantly more frequent in the patients with granuloma. Granuloma formation is mote often seen in younger patients, and mainly in the severe, active penetrating disease. CONCLUSION: The significantly higher frequency of surgical interventions and immunosuppressive therapy suggests that granuloma formation is associated with a more severe disease course during the first years of CD. 展开更多
关键词 Crohn's disease GRANULOMA ACTIVITY COMPLICATION
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Efficacy of 6-mercaptopurine treatment after azathioprine hypersensitivity in inflammatory bowel disease 被引量:2
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作者 ferenc nagy Tamás Molnár +3 位作者 Zoltán Szepes Klaudia Farkas Tibor Nyári János Lonovics 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第27期4342-4346,共5页
AIM:To investigate the efficacy of 6-mercaptopurine (6-MP) in cases of azathioprine (AZA) hypersensitivity in patients with inflammatory bowel disease. METHODS: Twenty nine previously confirmed Crohn’s disease (CD) (... AIM:To investigate the efficacy of 6-mercaptopurine (6-MP) in cases of azathioprine (AZA) hypersensitivity in patients with inflammatory bowel disease. METHODS: Twenty nine previously confirmed Crohn’s disease (CD) (n = 14) and ulcerative colitis (UC) (n = 15) patients with a known previous (AZA) hypersensitivity reaction were studied prospectively. The 6-MP doses were gradually increased from 0.5 up to 1.0-1.5 mg/kg per day. Clinical activity indicies (CDAI/CAI), laboratory variables and daily doses of oral 5-ASA, corticosteroids, and 6-MP were assessed before and in the first, sixth and twelfth months of treatment. RESULTS: In 9 patients, 6-MP was withdrawn in the first 2 wk due to an early hypersensitivity reaction. Medication was ineffective within 6 mo in 6 CD patients, and myelotoxic reaction was observed in two. Data were evaluated at the end of the sixth month in 12 (8 UC, 4 CD) patients, and after the first year in 9 (6 UC, 3 CD) patients. CDAI decreased transiently at the end of the sixth month, but no significant changes were observed in the CDAI or the CAI values at the end of the year. Leukocyte counts (P = 0.01), CRP (P = 0.02), and serum iron (P = 0.05) values indicated decreased inflammatory reactions, especially in the UC patients at the end of the year, making the possibility to taper oral steroid doses. CONCLUSION: About one-third of the previously AZA- intolerant patients showed adverse effects on taking 6MP. In our series, 20 patients tolerated 6MP, but it was ineffective in 8 CD cases, and valuable mainly in ulcerative colitis patients. 展开更多
关键词 Inflammatory bowel disease AZATHIOPRINE 6-MERCAPTOPURINE Side effects EFFICACY
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Frequency and prognostic role of mucosal healing in patients with Crohn's disease and ulcerative colitis after one-year of biological therapy 被引量:2
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作者 Klaudia Farkas Péter László Lakatos +8 位作者 Mónika Szcs va Pallagi-Kunstár Anita Bálint ferenc nagy Zoltán Szepes Noémi Vass Lajos S Kiss Tibor Wittmann Tamás Molnár 《World Journal of Gastroenterology》 SCIE CAS 2014年第11期2995-3001,共7页
AIM: To assess the endoscopic activity before and after a one-year period of biological therapy and to evaluate the frequency of relapses and need for retreatment after stopping the biologicals in patients with Crohn&... AIM: To assess the endoscopic activity before and after a one-year period of biological therapy and to evaluate the frequency of relapses and need for retreatment after stopping the biologicals in patients with Crohn&#x02019;s disease (CD) and ulcerative colitis (UC). 展开更多
关键词 Crohn’ s disease Ulcerative colitis Biological therapy Endoscopy Mucosal healing
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A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine 被引量:1
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作者 ferenc nagy Tamas Molnar +5 位作者 Eva Makula Ildiko Kiss Peter Milassin Eva Zollei Laszlo Tiszlavicz Janos Lonovics 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第2期316-319,共4页
The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with ... The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever, cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed, and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection, azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug. 展开更多
关键词 Inflammatory bowel disease Ulcerative colitis AZATHIOPRINE Interstitial pneumonitis
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Utility of serum TNF-a,infliximab trough level,and antibody titers in inflammatory bowel disease 被引量:1
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作者 va Pallagi-Kunstár Klaudia Farkas +7 位作者 Zoltán Szepes ferenc nagy Mónika Szucs Róbert Kui Rolland Gyulai Anita Bálint Tibor Wittmann Tamás Molnár 《World Journal of Gastroenterology》 SCIE CAS 2014年第17期5031-5035,共5页
AIM:To assess tumor necrosis factor-a(TNF-a),infliximab(IFX)concentrations,and antibodies against IFX molecules in patients with inflammatory bowel disease(IBD)who develop loss of response,side effects,or allergic rea... AIM:To assess tumor necrosis factor-a(TNF-a),infliximab(IFX)concentrations,and antibodies against IFX molecules in patients with inflammatory bowel disease(IBD)who develop loss of response,side effects,or allergic reaction during anti TNF-a therapy.METHODS:Blood samples of 36 patients with response loss,side effects,or hypersensitivity to IFX therapy(Group?Ⅰ)and 31 patients in complete clinical remission(GroupⅡ)selected as a control group were collected to measure trough serum TNF-a level,IFX,and anti-IFX antibody(ATI)concentration.We examined the correlation between loss of response,the development of side effects or hypersensitivity,and serum TNF-a,IFX trough levels,and ATI concentrations.RESULTS:The serum TNF-a level was shown to be correlated with the presence of ATI;ATI positivity was significantly correlated with low trough levels of IFX.ATIs were detected in 25%of IBD patients with loss of response,side effects,or hypersensitivity,however no association was revealed between these patients and antibody positivity or lower serum IFX levels.Previous use of IFX correlated with the development of ATI,although concomitant immunosuppression did not have any impact on them.CONCLUSION:On the basis of the present study,we suggest that the simultaneous measurement of serum TNF-a level,serum anti TNF-a concentration,and antibodies against anti TNF-a may further help to optimize the therapy in critical situations. 展开更多
关键词 Tumor necrosis factor-a INFLIXIMAB ANTIBODY Inflammatory bowel disease
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Analysis of risk factors-especially different types of plexitis-for postoperative relapse in Crohn's disease 被引量:1
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作者 Agnes Milassin Anita Sejben +10 位作者 László Tiszlavicz Zita Reisz Gyorgy Lázár Mónika Szucs Renáta Bor Anita Bálint Mariann Rutka Zoltán Szepes ferenc nagy Klaudia Farkas Tamás Molnár 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2017年第7期167-173,共7页
AIM To evaluate the presence of submucosal and myenteric plexitis and its role in predicting postoperative recurrence.METHODS Data from all patients who underwent Crohn's disease(CD)-related resection at the Unive... AIM To evaluate the presence of submucosal and myenteric plexitis and its role in predicting postoperative recurrence.METHODS Data from all patients who underwent Crohn's disease(CD)-related resection at the University of Szeged, Hungary between 2004 and 2014 were analyzed retrospectively. Demographic data, smoking habits, previous resection, treatment before and after surgery, resection margins, neural fiber hyperplasia, submucosal and myenteric plexitis were evaluated as possible predictors of postoperative recurrence. Histological samples were analyzed blinded to the postoperative outcome and the clinical history of the patient. Plexitis was evaluated based on the appearance of the most severely inflamed ganglion or nerve bundle. Patients underwent regular follow-up with colonoscopy after surgery. Postoperativerecurrence was defined on the basis of endoscopic and clinical findings, and/or the need for additional surgical resection. RESULTS One hundred and four patients were enrolled in the study. Ileocecal, colonic, and small bowel resection were performed in 73.1%, 22.1% and 4.8% of the cases, respectively. Mean disease duration at the time of surgery was 6.25 years. Twenty-six patients underwent previous CD-related surgery. Forty-three point two percent of the patients were on 5-aminosalicylate, 20% on corticosteroid, 68.3% on immunomodulant, and 4% on anti-tumor necrosis factor-alpha postoperative treatment. Postoperative recurrence occurred in 61.5% of the patients; of them 39.1% had surgical recurrence. 92.2% of the recurrences developed within the first five years after the index surgery. Mean disease duration for endoscopic relapse was 2.19 years. The severity of submucosal plexitis was a predictor of the need for second surgery(OR = 1.267, 95%CI: 1.000-1.606, P = 0.050). Female gender(OR = 2.21, 95%CI: 0.98-5.00, P = 0.056), stricturing disease behavior(OR = 3.584, 95%CI: 1.344-9.559, P = 0.011), and isolated ileal localization(OR = 2.671, 95%CI: 1.033-6.910, P = 0.043) were also predictors of postoperative recurrence. No association was revealed between postoperative recurrence and smoking status, postoperative prophylactic treatment and the presence of myenteric plexitis and relapse.CONCLUSION The presence of severe submucosal plexitis with lymphocytes in the proximal resection margin is more likely to result in postoperative relapse in CD. 展开更多
关键词 Submucosal plexitis Postoperative recurrence Crohn’s disease Stricturing disease behavior Isolated ileal disease
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NOD2/CARD15 gene polymorphism in patients with inflammatory bowel disease: Is Hungary different? 被引量:1
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作者 Carsten Büning Tomas Molnar +6 位作者 ferenc nagy Janos Lonovics Renita Weltrich Bettina Bochow Janine Genschel Hartmut Schmidt Herbert Lochs 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第3期407-411,共5页
AIM: To analyse the impact of NOD2/CARD15 mutations on the clinical course of Crohn 's disease patients from an eastern European country (Hungary). METHODS: We investigated the prevalence of the three common NOD2/... AIM: To analyse the impact of NOD2/CARD15 mutations on the clinical course of Crohn 's disease patients from an eastern European country (Hungary). METHODS: We investigated the prevalence of the three common NOD2/CARD15 mutations (Arg702Trp, Gly908Arg, 1007finsC) in 148 patients with Crohn's disease, 128 patients with ulcerative colitis and 208 controls recruited from the University of Szeged, Hungary. In patients with Crohn 's disease, the prevalence of NOD2/CARD15 mutations was correlated to the demographical and clinical parameters. RESULTS: In total, 32.4% of Crohn's disease patients carried at least one mutant allele within NOD2/CARD15 compared to 13.2% of patients with ulcerative colitis (P = 0.0002) and to 11.5% of controls (P<O.0001). In Crohn's disease patients, the allele frequencies for Arg702Trp, Gly908Arg and 1007finsC were 7.1%, 3.0% and 10.8% respectively. Interestingly, only the 1007finsC mutation was associated with a distinct clinical phenotype. The patients positive for the 1007finsC mutation suffered more frequently from stenotic disease behaviour (P= 0.008). Furthermore, 51.9% of patients positive for the 1007finsC mutation underwent a surgical resection within the ileum compared to only 17.4% of patients without the 1007finsC mutation (P = 0.001). With respect to the other two mutations (Arg702Trp and Gly908Arg), no associations were found with all investigated clinical parameters. CONCLUSION: NOD2/CARD15 mutations are frequently found in Crohn's disease patients from Hungary. The 1007finsC mutation is associated with stenotic disease behaviour and frequent ileal resections. 展开更多
关键词 Crohn's disease NOD2/CARD15 gene MUTATION
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What Is the Personal Experience of IBD Patients about Their Anti-TNF-Alpha Therapy?
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作者 Agnes Milassin Mariann Rutka +10 位作者 Agnes Anna Csontos Pal Miheller Karoly Palatka Monika Szucs Zoltan Szepes Anita Balint Renata Bor Anna Fabian Klaudia Farkas ferenc nagy Tamas Molnar 《Health》 2017年第7期1007-1018,共12页
AIM: To evaluate and compare the patients opinion on the two types of anti- TNF-α therapies in a Hungarian cohort of IBD patients. METHODS: This was a prospective, multicentre, questionnaire-based observational study... AIM: To evaluate and compare the patients opinion on the two types of anti- TNF-α therapies in a Hungarian cohort of IBD patients. METHODS: This was a prospective, multicentre, questionnaire-based observational study carried out in three Hungarian tertiary centres. From April to September 2014, an anonymous questionnaire was distributed to patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD), who have received infliximab (IFX) and/or adalimumab (ADA). The survey focused on the preferences of the two anti-TNF-α therapies on the basis of the efficacy, the administration routes and the side effects. RESULTS: 292 IBD patients, 216 CD, 75 UC and 1 indeterminate colitis patient completed the questionnaire. The mean duration of biological therapy was 1.7 (1 - 7) years. IFX treated patients noticed improvement of symptoms at 4 - 5 weeks while ADA treated patients noticed at 5 - 6 weeks. There was no difference between the patients’ satisfaction regarding the types of anti-TNF-α therapy if they received both. However, subcutaneous administration was preferred by ADA-treated patients previously receiving IFX (p = 0.007) compared to intravenous route and they did not intend to change the mode of therapy (p = 0.040). 90% of the patients, receiving only IFX or ADA were satisfied with their present therapy. The majority of patients (186/292, 63.7%) would not switch therapy. 63 of 291, 22% of the patients reported to have some concern with biological therapy—the majority (32/63, 50.8%) due to fear from side effects. CONCLUSION: Generally, patients preferred and would not change the present anti-TNF-α therapy, however, subcutaneous administration was preferred among those patients who had have experience with both. 展开更多
关键词 Patient’s Satisfaction Personal Experience QUESTIONNAIRE Anti-TNF-Alpha Therapy Patient’s Preference
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Thermal Reversion of Plant Phytochromes 被引量:7
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作者 Cornelia Klose ferenc nagy Eberhard Schafer 《Molecular Plant》 SCIE CAS CSCD 2020年第3期386-397,共12页
Phytochromes are red/far-red reversible photoreceptors essential for plant growth and development.Phytochrome signaling is mediated by the physiologically active far-red-absorbing Pfr form that can be inactivated to t... Phytochromes are red/far-red reversible photoreceptors essential for plant growth and development.Phytochrome signaling is mediated by the physiologically active far-red-absorbing Pfr form that can be inactivated to the red-absorbing Pr ground state by light-dependent photoconversion or by light-independent thermal reversion,also termed dark reversion.Although the term“dark reversion”is justified by historical reasons and frequently used in the literature,“thermal reversion”more appropriately describes the process of light-independent but temperature-regulated Pfr relaxation that not only occurs in darkness but also in light and is used throughout the review.Thermal reversion is a critical parameter for the light sensitivity of phytochrome-mediated responses and has been studied for decades,often resulting in contradictory findings.Thermal reversion is an intrinsic property of the phytochrome molecules but can be modulated by intra-and intermolecular interactions,as well as biochemical modifications,such as phosphorylation.In this review,we outline the research history of phytochrome thermal reversion,highlighting important predictions that have been made before knowing the molecular basis.We further summarize and discuss recent findings about the molecular mechanisms regulating phytochrome thermal reversion and its functional roles in light and temperature sensing in plants. 展开更多
关键词 PHYTOCHROME PHYA PHYB thermal reversion dark reversion in vivo spectroscopy
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A Short Amino-Terminal Part of Arabidopsis Phytochrome A Induces Constitutive Photomorphogenic Response 被引量:3
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作者 Andra's Viczia'n E'va Ada'm +6 位作者 Iris Wolf Ja'nos Bindics Stefan Kircher Marc Heijde Roman Ulm Eberhard Scha'fer ferenc nagy 《Molecular Plant》 SCIE CAS CSCD 2012年第3期629-641,共13页
Phytochrome A (phyA) is the dominant photoreceptor of far-red light sensing in Arabidopsis thaliana, phyA accumulates at high levels in the cytoplasm of etiolated seedlings, and light-induced phyA signaling is media... Phytochrome A (phyA) is the dominant photoreceptor of far-red light sensing in Arabidopsis thaliana, phyA accumulates at high levels in the cytoplasm of etiolated seedlings, and light-induced phyA signaling is mediated by a com- plex regulatory network. This includes light- and FHY1/FHL protein-dependent translocation of native phyA into the nucleus in vivo. It has also been shown that a short N-terminal fragment of phyA (PHYA406) is sufficient to phenocopy this highly regulated cellular process in vitro. To test the biological activity of this N-terminal fragment of phyA in planta, we produced transgenic phyA-201 plants expressing the PHYA406-YFP (YELLOW FLUORESCENT PROTEIN)-DD, PHYA406- YFP-DD-NLS (nuclear localization signal), and PHYA406-YFP-DD-NES (nuclear export signal) fusion proteins. Here, we report that PHYA406-YFP-DD is imported into the nucleus and this process is partially light-dependent whereas PHYA406-YFP-DD-NLS and PHYA406-YFP-DD-NES display the expected constitutive localization patterns. Our results show that these truncated phyA proteins are light-stable, they trigger a constitutive photomorphogenic-like response when localized in the nuclei, and neither of them induces proper phyA signaling. We demonstrate that in vitro and in vivo PHYA406 Pfr and Pr bind COP1, a general repressor of photomorphogenesis, and co-localize with it in nuclear bodies. Thus, we conclude that, in planta, the truncated PHYA406 proteins inactivate COP1 in the nuclei in a light-independent fashion. 展开更多
关键词 ARABIDOPSIS cop phenotype phytochrome A COP1
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Light Triggers the miRNA-Biogenetic Inconsistency for De-etiolated Seedling Survivability in Arabidopsis thaliana 被引量:5
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作者 Suk Won Choi Moon Young Ryu +11 位作者 Andras Viczian Hyun Ju Jung Gu Min Kim Agustin LArce Natalia PAchkar Pablo Manavella Ulla Dolde Stephan Wenke Attila Molnar ferenc nagy Seok Keun Cho Seong Wook Yang 《Molecular Plant》 SCIE CAS CSCD 2020年第3期431-445,共15页
The shift of dark-grown seedlings into light causes enormous transcriptome changes followed by a dramatic developmental transition.Here,we show that microRNA(miRNA)biogenesis also undergoes regulatory changes during d... The shift of dark-grown seedlings into light causes enormous transcriptome changes followed by a dramatic developmental transition.Here,we show that microRNA(miRNA)biogenesis also undergoes regulatory changes during de-etiolation.Etiolated seedlings maintain low levels of primary miRNAs(pri-miRNAs)and miRNA processing core proteins,such as Dicer-like 1,SERRATE,and HYPONASTIC LEAVES 1,whereas during de-etiolation both pri-miRNAs and the processing components accumulate to high levels.However,the levels of most miRNAs do not notably increase in response to light.To reconcile this inconsistency,we demonstrated that an unknown suppressor decreases miRNA-processing activity and light-induced SMALL RNA DEGRADING NUCLEASE 1 shortens the half-life of several miRNAs in de-etiolated seedlings.Taken together,these data suggest a novel mechanism,miRNA-biogenetic inconsistency,which accounts for the intricacy of miRNA biogenesis during de-etiolation.This mechanism is essential for the survival of de-etiolated seedlings after long-term skotomorphogenesis and their optimal adaptation to ever-changing light conditions. 展开更多
关键词 Light signaling miRNA biogenesis
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