Avtor/Urednik		Ferkolj, Ivan
Naslov		Imunski odziv ob zdravljenju Crohnove bolezni s himernimi monoklonskimi protitelesi proti TNF-alfa
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2004
Obseg		str. 93
Jezik		slo
Abstrakt		Crohn's disease (CD) is a chronic inflammatory bowel disease. Standard medical treatment is directed towards nonspecific suppression of inflammation. However, a substantial number of patients have serious side effects or do not respond to this therapy. The search for new drugs is mainly focused on the immune cascade and cytokine interactions. TNF-alpha is a typical pro-inflammatory cytokin and is considered to play a pivotal role in CD. This has led to the treatment that blocks TNF-alpha effects. Infliximab is genetically constructed IgG1 murine-human chimeric anti TNF-alpha monoclonal antibody and induces clinical improvement in the majority of patients. The first hypothesis of the study was that treatment with infliximab important changes number and activity of the lymphocytes in periferal blood and in inflamed mucosa, profoundly downregulates inflammation and leads to clinical improvement. The second hypothesis was, that treatment with infliximab has influence on synthesis of IFN-gamma and IL-4 in lymphocytes in peripheral blood and in inflammed mucosa. The third hypothesis was that measurement of the immunological parameters in periferal blood and in inflamed mucosa before the treatment with infliximab can predict the effect of therapy 3 months later. Infliximab was administered to 25 patients with CD, resistant to all conventional therapy, at a dose of 5 mg/kg. Patients with active luminal disease (11) received a single dose, while those with fistulas (14) recieved two additional doses at week 2 and 6. Flow-cytometricaly, we analyzed the peripheral blood and mucosal lymphocyte populations before the treatment and 14 days later to evaluate immunological changes. We also compared the results before treatment with clinical response in patients three months after. (Abstract truncated at 2000 characters).
Deskriptorji		CROHN DISEASE ANTIBODIES, MONOCLONAL TUMOR NECROSIS FACTOR TREATMENT OUTCOME FLOW CYTOMETRY T-LYMPHOCYTE SUBSETS ANTIGENS, CD3 ANTIGENS, CD4 ANTIGENS, CD8 ANTIGENS, CD19 TH1 CELLS TH2 CELLS INTESTINAL MUCOSA INTERFERON TYPE II INTERLEUKIN-4