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  • 1. Amcoff, K.
    et al.
    Joossens, M.
    Pierik, M. J.
    Jonkers, D.
    Bohr, J.
    Joossens, S
    Romberg-Camp, M.
    Nyhlin, Nils
    Wickbom, A.
    Rutgeerts, P. J.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Bodin, L.
    Colombel, J. F.
    Vermeire, S.
    Halfvarson, Jonas
    Arvets inverkan på serologiska markörer hos tvillingar med IBD2012Inngår i: Gastrokuriren, ISSN 1651-0453, Vol. 17, nr 26, s. MP-06-MP-06Artikkel i tidsskrift (Annet vitenskapelig)
  • 2. Amcoff, Karin
    et al.
    Joossens, Marie
    Pierik, Marie J.
    Jonkers, Daisy
    Bohr, Johan
    Joossens, Sofie
    Romberg-Camps, Marielle
    Nyhlin, Nils
    Wickbom, Anna K.
    Rutgeerts, Paul J.
    Tysk, Curt
    Bodin, Lennart
    Colombel, Jean-Frederic
    Vermeire, Severine
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning.
    Influence of genetics in the expression of serological markers in twins with IBD2012Inngår i: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 142, nr 5, s. S881-S881Artikkel i tidsskrift (Annet vitenskapelig)
  • 3.
    Amcoff, Karin
    et al.
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Joossens, Marie
    Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit, Leuven,Belgium; VIB Center for the Biology of Disease, Leuven, Belgium; Microbiology Unit, Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit, Brussels, Belgium.
    Pierik, Marie J.
    Gastroenterology, University Hospital Maastricht, Maastricht, The Netherlands.
    Jonkers, Daisy
    Gastroenterology, University Hospital Maastricht, Maastricht, The Netherlands.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Joossens, Sofie
    Gastroenterology, Catholic University of Leuven (KUL), Leuven, Belgium.
    Romberg-Camps, Mariëlle
    Department of Gastroenterology-Hepatology, Zuyderland Medical Center, Sittard, Netherlands.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Rutgeerts, Paul J.
    Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
    Tysk, Curt
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Bodin, Lennart
    Institute of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institute, Stockholm, Sweden.
    Colombel, Jean-Frederic
    Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York NY, USA.
    Vermeire, Severine
    Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Concordance in Anti-OmpC and Anti-I2 Indicate the Influence of Genetic Predisposition: Results of a European Study of Twins with Crohn's Disease2016Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 10, nr 6, s. 695-702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Aims: An adaptive immunological response to microbial antigens has been observed in Crohn's disease (CD). Intriguingly, this serological response precedes the diagnosis in some patients and has also been observed in healthy relatives. We aimed to determine whether genetic factors are implicated in this response in a CD twin cohort.

    Methods: In total, 82 twin pairs (Leuven n = 13, Maastricht n = 8, Örebro n = 61) took part: 81 pairs with CD (concordant monozygotic n = 16, discordant monozygotic n = 22, concordant dizygotic n = 3, discordant dizygotic n = 40) and 1 monozygotic pair with both CD and ulcerative colitis. Serology for Pseudomonas fluorescens-related protein (anti-I2), Escherichia coli outer membrane porin C (anti-OmpC), CBir1flagellin (anti-CBir1) and antibodies to oligomannan (anti-Saccharomyces cerevisiae antibody [ASCA]) was determined by standardized enzyme-linked immunoassay.

    Results: All markers were more often present in CD twins than in their healthy twin siblings. Using the intraclass correlation coefficient (ICC), agreements in concentrations of anti-OmpC and anti-I2 were observed in discordant monozygotic but not in discordant dizygotic twin pairs with CD (anti-OmpC, ICC 0.80 and -0.02, respectively) and (anti-I2, ICC 0.56 and 0.05, respectively). In contrast, no agreements were found in anti-CBir, immunoglobulin (Ig) G ASCA and ASCA IgA.

    Conclusions: We show that anti-I2 and anti-CBir1 statuses have specificity for CD and confirm previous reported specificities for anti-OmpC and ASCA. Based on quantitative analyses and observed ICCs, genetics seems to predispose to the anti-OmpC and anti-I2 response but less to ASCA and anti-CBir1 responses.

  • 4.
    Bohr, Johan
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Hegedus, Agnes
    Department of Laboratory Medicine/Pathology, Örebro University Hospital, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Hultgren-Hörnquist, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Diagnosis and management of microscopic colitis: Current perspectives2014Inngår i: Clinical and Experimental Gastroenterology, ISSN 1178-7023, E-ISSN 1178-7023, Vol. 7, s. 273-284Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Collagenous colitis and lymphocytic colitis, together constituting microscopic colitis, are common causes of chronic diarrhea. They are characterized clinically by chronic nonbloody diarrhea and a macroscopically normal colonic mucosa where characteristic histopathological findings are seen. Previously considered rare, they now have emerged as common disorders that need to be considered in the investigation of the patient with chronic diarrhea. The annual incidence of each disorder is five to ten per 100,000 inhabitants, with a peak incidence in 60- to 70-year-old individuals and a predominance of female patients in collagenous colitis. The etiology and pathophysiology are not well understood, and the current view suggests an uncontrolled mucosal immune reaction to various luminal agents in predisposed individuals. Clinical symptoms comprise chronic diarrhea, abdominal pain, fatigue, weight loss, and fecal incontinence that may impair the patient's health-related quality of life. An association is reported with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. The best-documented treatment, both short-term and long-term, is budesonide, which induces clinical remission in up to 80% of patients after 8 weeks' treatment. However, after successful budesonide therapy is ended, recurrence of clinical symptoms is common, and the best possible long-term management deserves further study. The long-term prognosis is good, and the risk of complications, including colonic cancer, is low. We present an update of the epidemiology, pathogenesis, diagnosis, and management of microscopic colitis.

  • 5.
    Fransén, Karin
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Franzén, Petra
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Magnuson, Anders
    Örebro University Hospital, Örebro, Sweden.
    Elmabsout, Ali
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nyhlin, Nils
    Region Örebro län.
    Wickbom, Anna
    Örebro University Hospital, Örebro, Sweden.
    Curman, Bengt
    Örebro University Hospital, Örebro, Sweden.
    Törkvist, Leif
    Karolinska University Hospital, Stockholm, Sweden.
    D'Amato, Mauro
    Karolinska University Hospital, Stockholm, Sweden.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Sirsjö, Allan
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län.
    Polymorphism in the retinoic acid metabolizing enzyme CYP26B1 and the development of Crohn's disease2013Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 8, s. e72739-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Several studies suggest that Vitamin A may be involved in the pathogenesis of inflammatory bowel disease (IBD), but the mechanism is still unknown. Cytochrome P450 26 B1 (CYP26B1) is involved in the degradation of retinoic acid and the polymorphism rs2241057 has an elevated catabolic function of retinoic acid, why we hypothesized that the rs2241057 polymorphism may affect the risk of Crohn's disease (CD) and Ulcerative Colitis (UC). DNA from 1378 IBD patients, divided into 871 patients with CD and 507 with UC, and 1205 healthy controls collected at Örebro University Hospital and Karolinska University Hospital were analyzed for the CYP26B1 rs2241057 polymorphism with TaqMan® SNP Genotyping Assay followed by allelic discrimination analysis. A higher frequency of patients homozygous for the major (T) allele was associated with CD but not UC compared to the frequency found in healthy controls. A significant association between the major allele and non-stricturing, non-penetrating phenotype was evident for CD. However, the observed associations reached borderline significance only, after correcting for multiple testing. We suggest that homozygous carriers of the major (T) allele, relative to homozygous carriers of the minor (C) allele, of the CYP26B1 polymorphism rs2241057 may have an increased risk for the development of CD, which possibly may be due to elevated levels of retinoic acid. Our data may support the role of Vitamin A in the pathophysiology of CD, but the exact mechanisms remain to be elucidated.

  • 6.
    Kumawat, Ashok Kumar
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nyhlin, Nils
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Hultgren, Olof
    Region Örebro län. Department of Microbiology and Immunology, Örebro University Hospital, Örebro, Sweden.
    Hultgren-Hörnquist, Elisabeth
    Örebro universitet, Institutionen för läkarutbildning.
    An In Vitro Model to Evaluate the Impact of the Soluble Factors from the Colonic Mucosa of Collagenous Colitis Patients on T Cells: Enhanced Production of IL-17A and IL-10 from Peripheral CD4(+) T Cells2014Inngår i: Mediators of Inflammation, ISSN 0962-9351, E-ISSN 1466-1861, artikkel-id 879843Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Soluble factors from intestinal mucosal cells contribute to immune homeostasis in the gut. We have established an in vitro model to investigate the regulatory role of soluble factors from inflamed intestinal mucosa of collagenous colitis (CC) patients in the differentiation of T cells. Peripheral blood CD4(+) T cells from healthy donors were polyclonally activated in the presence of conditioned medium (CM) generated from denuded biopsies (DNB) or isolated lamina propria mononuclear cells (LPMCs) from mucosal biopsies from CC patients compared to noninflamed controls, to determine proliferation and secretion of cytokines involved in T-cell differentiation. Compared to controls, we observed significantly increased production of the proinflammatory cytokines IFN-gamma, IL-17A, IL-6, and IL-1 beta and the anti-inflammatory cytokines IL-4 and IL-10 in the presence of CC-DNB-CM. The most pronounced effect of CC-LPMC-CM on peripheral CD4(+) T cells was a trend towards increased production of IL-17A and IL-10. A trend towards reduced inhibition of T-cell proliferation was noted in the presence of CC-DNB-CM. In conclusion, our in vitro model reveals implications of soluble factors from CC colonic mucosa on peripheral T cells, enhancing their production of both pro-and anti-inflammatory cytokines.

  • 7. Nyhlin, Nils
    et al.
    Bohr, Johan
    Örebro universitet, Hälsoakademin.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Brummer, Robert
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wickbom, Anna
    Tysk, Curt
    Örebro universitet, Hälsoakademin.
    Abdominal pain is common in microscopic colitis despite remission: a long-term follow-up of 203 patients2008Inngår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 57, nr suppl IArtikkel i tidsskrift (Annet vitenskapelig)
  • 8.
    Nyhlin, Nils
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott M.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Letter: persisting clinical symptoms in microscopic colitis in remission - authors' reply2014Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 40, nr 1, s. 118-118Artikkel i tidsskrift (Fagfellevurdert)
  • 9.
    Nyhlin, Nils
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Medicine, Division of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Montgomery, Scott M.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Tysk, Curt
    Region Örebro län. Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Long-term prognosis of clinical symptoms and health-related quality of life in microscopic colitis: a case-control study2014Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 39, nr 9, s. 963-972Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Microscopic colitis, comprising collagenous colitis (CC) and lymphocytic colitis (LC), is a common cause of chronic diarrhoea. The long-term prognosis is not well described.

    Aim: To study outcome of symptoms and health-related quality of life (HRQoL).

    Methods: A case-control study using a postal questionnaire with three population-based controls per patient matched for age, sex and municipality. HRQoL was assessed by the Short Health Scale (SHS). Patients in clinical remission, defined as a mean of <3 stools/day, were evaluated separately (CC; n=72, LC; n=60).

    Results: The study included 212 patients and 627 matched controls. Median disease duration was 5.9 (range 0.5-27) years and 6.4 (0.3-14.8) years for CC and LC respectively. Abdominal pain, fatigue, arthralgia, myalgia, faecal incontinence and nocturnal defecation were significantly more prevalent in CC patients compared with controls. These differences persisted in CC patients in clinical remission with respect to abdominal pain (36% vs. 21%), fatigue (54% vs. 34%), arthralgia (61% vs. 41%) and myalgia (53% vs. 37%). In LC patients, abdominal pain, fatigue, faecal incontinence and nocturnal defecation were more prevalent compared with controls. In LC patients in clinical remission, fatigue was more prevalent compared with controls (54% vs. 37%). These differences were statistically significant (P<0.05). All four HRQoL dimensions (symptom burden, social function, disease-related worry, general well-being) were impaired in patients with active CC and LC.

    Conclusions: Although considered to be in clinical remission, patients with microscopic colitis suffer from persisting symptoms such as abdominal pain, fatigue, arthralgia or myalgia several years after diagnosis.

  • 10.
    Svensson, Magnus
    et al.
    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Bergman, David
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Olén, Ola
    Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden.
    Myrelid, Pär
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Surgery, Linköping University Hospital, Linköping, Sweden.
    Bohr, Johan
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Khalili, Hamed
    Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Gastroenterology Unit , Crohn's and Colitis Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
    Münch, Andreas
    Department of Gastroenterology, Linköping University Hospital, Linköping, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Epidemiology and Public Health School of Medicine, University of Nottingham, Nottingham, UK; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
    Validating microscopic colitis (MC) in Swedish pathology registers2018Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Microscopic colitis (MC), encompassing collagenous colitis (CC) and lymphocytic colitis (LC), is a diagnosis which relies on histopathologic criteria. This report examines the validity of having a diagnosis of MC in Swedish pathology registers.

    METHODS: We reviewed patient charts from 215 randomly selected individuals from 15 pathology departments in five healthcare regions in Sweden with a relevant histopathology code for MC on colon biopsies. Information on clinical symptoms and laboratory data were obtained from medical chart review. We obtained sufficient data on 211 individuals for calculating positive predictive values (PPVs) for MC.

    RESULTS: In total, 200/211 patients with a histopathology diagnosis of MC were confirmed as also having a clinical diagnosis of MC after chart review, yielding a PPV of 95% (95%CI =91-97%). The PPV for CC was 95% (95%CI =87-98%) and 85% for LC (95%CI =78-90%). The median age at biopsy was 67 years (range 17-90 years), and 72% (n = 154) were women. The most common symptoms in patients with MC histopathology were diarrhea (96% of patients), weight loss (24%) and abdominal pain (13%). Four percent (4/111) of patients with available data on stool culture were positive for gastrointestinal pathogens (none had Clostridium difficile). In 81 patients with available celiac serology, five (6%) were positive. Twenty-six percent of all patients had at least one other autoimmune disease, the most frequent being hypothyroidism (8%) and celiac disease (6%).

    CONCLUSIONS: This study found a high validity for MC as recorded in Swedish pathology registers.

  • 11.
    Tysk, Curt
    et al.
    Örebro universitet, Hälsoakademin.
    Bohr, Johan
    Nyhlin, Nils
    Wickbom, Anna
    Eriksson, Sune
    Diagnosis and management of microscopic colitis2008Inngår i: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 14, nr 48, s. 7280-7288Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Microscopic colitis, comprising collagenous and lymphocytic colitis, is characterized clinically by chronic watery diarrhea, and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100,000 inhabitants, with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue and fecal incontinence are common symptoms, which impair the health-related quality of life of the patient. There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented short-term treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.

  • 12.
    Tysk, Curt
    et al.
    Örebro universitet, Hälsoakademin.
    Wickbom, Anna
    Nyhlin, Nils
    Eriksson, Sune
    Bohr, Johan
    Recent advances in diagnosis and treatment of microscopic colitis2011Inngår i: Annals of Gastroenterology, ISSN 1108-7471, E-ISSN 1792-7463, Vol. 24, nr 4, s. 253-262Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Microscopic colitis, comprising collagenous colitis and lymphocytic colitis, is a common cause of chronic diarrhoea. It is characterised clinically by chronic watery diarrhoea and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100000 inhabitants, with a peak incidence in individuals 60-70 years old and a noticeable female predominance in collagenous colitis. The aetiology is unknown. Chronic diarrhoea, abdominal pain, weight loss, fatigue, and faecal incontinence are common symptoms that impair the health-related quality of life of the patient. There is an association with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. Budesonide is the best-documented treatment, both short-term and long-term. Recurrence of symptoms is common after withdrawal of successful budesonide therapy, and the optimal long-term treatment strategy needs further study. The long-term prognosis is good, and the risk of complications including colonic cancer is low. We review epidemiology, clinical features, diagnosis and treatment of microscopic colitis,

  • 13.
    Wickbom, Anna
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Epidemiological aspects of microscopic colitis2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Microscopic colitis (MC) constitutes the main entities collagenous colitis (CC) and lymphocytic colitis (LC), diseases that are relatively recently described (in 1976 and 1989, respectively).

    The aims of this thesis were to study the epidemiology of MC, to describe how these diseases affect patients in terms of symptom burden and health-related quality of life (HRQoL), to study potential risk factors such as familial factors, childhood circumstances, educational level, marital status, smoking and comorbidity, and to describe a cohort of patients with ulcerative colitis (UC) or Crohn’s disease (CD) and subsequent MC, and vice versa.

    During 1999–2008 in Sweden, the mean annual incidence of MC was 10.2 per 105 inhabitants, compared with 5.2 per 105 inhabitants for CC, and 5.0 per 105 inhabitants for LC. The prevalence of MC on 31 December 2008 was 123 per 105 inhabitants. Women appeared to be especially affected – the female:male ratio was 3.6:1 in CC and 4.6:1 in LC.

    Patients’ HRQoL is impaired both in active CC and in LC. Patients with CC in clinical remission have persisting symptoms: abdominal pain, fatigue, arthralgia and myalgia; LC patients in remission have persistent fatigue compared with controls. This illustrates that the longterm outcome is different in CC compared with LC.

    Microscopic colitis is associated with a family history of MC, indicating that familial factors may play a role in the pathogenesis of this disease. We confirm earlier reports that smoking is a risk factor in MC.

    In the present study population, CC was associated with rheumatic disease and previous appendicectomy. Moreover, CC and LC were associated with thyroid disease and coeliac disease and, interestingly, with a history of UC.

    Most patients with UC or CD and subsequent MC, or vice versa, had UC or CD first and later developed MC. The majority had extensive UC and later onset of CC. Microscopic colitis should be considered in patients with UC or CD if there is onset of chronic watery diarrhoea without endoscopic relapse of mucosal inflammation.

    Delarbeid
    1. Stable Incidence of Collagenous Colitis and Lymphocytic Colitis in Orebro, Sweden, 1999-2008: A Continuous Epidemiologic Study
    Åpne denne publikasjonen i ny fane eller vindu >>Stable Incidence of Collagenous Colitis and Lymphocytic Colitis in Orebro, Sweden, 1999-2008: A Continuous Epidemiologic Study
    Vise andre…
    2013 (engelsk)Inngår i: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 19, nr 11, s. 2387-2393Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: The incidence of microscopic colitis (MC) has increased in several centers, but long-term epidemiologic data are missing. We report an epidemiologic study of collagenous colitis (CC) and lymphocytic colitis (LC) during 1999-2008, as a follow-up of our previous studies 1984-1998. Methods: Population-based study of residents of the catchment area of the hospital, with a new diagnosis of MC between 1999 and 2008. Patients were identified by diagnosis registers of the Departments of Medicine and Pathology. Medical files were reviewed, and colonic biopsies were reevaluated. Results: Collagenous colitis was diagnosed in 96 patients (75 females) and LC in 90 patients (74 females). The mean annual age-standardized incidence (per 100,000 inhabitants) was MC 10.2 (95% confidence interval: 8.7-11.7), CC 5.2 (4.2-6.3), and LC 5.0 (4.0-6.0). Age-specific incidence showed a peak in females older than 70 years. Prevalence (per 100,000 inhabitants) on December 31, 2008, was MC 123 (107.6-140.0), CC 67.7 (56.4-80.6), and LC 55.3 (45.2-67.1). A comparison of current study period with 1993-1998 showed unchanged mean incidence of MC, but a 2-fold increase in women older than 60 years with LC (standardized rate ratios 2.2, [1.2-3.7]) and increased female to male ratio (4.6:1 versus 2.1:1; P = 0.02) in LC. Conclusions: After an initial rise during 1980s and early 1990s, annual incidence of CC and LC has been stable during the last 15 years around 5/100,000 inhabitants for each disorder. The increasing incidence in older women with LC may be related to an increasing proportion of older individuals in the background population and increased colonoscopy frequency in elderly.

    Emneord
    microscopic colitis, collagenous colitis, lymphocytic colitis, incidence, prevalence, celiac disease
    HSV kategori
    Forskningsprogram
    Medicin
    Identifikatorer
    urn:nbn:se:oru:diva-33714 (URN)10.1097/MIB.0b013e31829ed8cd (DOI)000329354500014 ()
    Merknad

    Funding Agencies:

    Örebro County Research Committee  

    Örebro University  

    AstraZeneca  

    Swedish Society of Gastroenterology  

    International Organization for the Study of Inflammatory Bowel Diseases 

    Tilgjengelig fra: 2014-02-12 Laget: 2014-02-12 Sist oppdatert: 2018-09-13bibliografisk kontrollert
    2. Long-term prognosis of clinical symptoms and health-related quality of life in microscopic colitis: a case-control study
    Åpne denne publikasjonen i ny fane eller vindu >>Long-term prognosis of clinical symptoms and health-related quality of life in microscopic colitis: a case-control study
    Vise andre…
    2014 (engelsk)Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 39, nr 9, s. 963-972Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Microscopic colitis, comprising collagenous colitis (CC) and lymphocytic colitis (LC), is a common cause of chronic diarrhoea. The long-term prognosis is not well described.

    Aim: To study outcome of symptoms and health-related quality of life (HRQoL).

    Methods: A case-control study using a postal questionnaire with three population-based controls per patient matched for age, sex and municipality. HRQoL was assessed by the Short Health Scale (SHS). Patients in clinical remission, defined as a mean of <3 stools/day, were evaluated separately (CC; n=72, LC; n=60).

    Results: The study included 212 patients and 627 matched controls. Median disease duration was 5.9 (range 0.5-27) years and 6.4 (0.3-14.8) years for CC and LC respectively. Abdominal pain, fatigue, arthralgia, myalgia, faecal incontinence and nocturnal defecation were significantly more prevalent in CC patients compared with controls. These differences persisted in CC patients in clinical remission with respect to abdominal pain (36% vs. 21%), fatigue (54% vs. 34%), arthralgia (61% vs. 41%) and myalgia (53% vs. 37%). In LC patients, abdominal pain, fatigue, faecal incontinence and nocturnal defecation were more prevalent compared with controls. In LC patients in clinical remission, fatigue was more prevalent compared with controls (54% vs. 37%). These differences were statistically significant (P<0.05). All four HRQoL dimensions (symptom burden, social function, disease-related worry, general well-being) were impaired in patients with active CC and LC.

    Conclusions: Although considered to be in clinical remission, patients with microscopic colitis suffer from persisting symptoms such as abdominal pain, fatigue, arthralgia or myalgia several years after diagnosis.

    sted, utgiver, år, opplag, sider
    Hoboken: Wiley-Blackwell, 2014
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-34938 (URN)10.1111/apt.12685 (DOI)000333553000007 ()24612051 (PubMedID)2-s2.0-84898601507 (Scopus ID)
    Merknad

    Funding Agencies:

    Örebro University Hospital Research Foundation (Nyckelfonden)

    Swedish Society of Medicine (Bengt Ihre Foundation)

    Örebro County Research Committee

    Tilgjengelig fra: 2014-05-05 Laget: 2014-05-05 Sist oppdatert: 2018-07-22bibliografisk kontrollert
    3. Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study
    Åpne denne publikasjonen i ny fane eller vindu >>Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study
    Vise andre…
    2017 (engelsk)Inngår i: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 29, nr 5, s. 587-594Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVES: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited.

    AIM: The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis.

    METHODS: A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality.

    RESULTS: Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, P<0.001) and LC (OR: 3.2; 95% CI: 1.6-6.7, P=0.002). The median age at diagnosis was around 10 years earlier in ever-smokers compared with never-smokers.CC was associated with a history of ulcerative colitis (UC) (OR: 8.7, 95% CI: 2.2-33.7, P=0.002), thyroid disease (OR: 2.3; 95% CI: 1.1-4.5, P=0.02), coeliac disease (OR: 13.1; 95% CI: 2.7-62.7, P=0.001), rheumatic disease (OR 1.9; 95% CI: 1.0-3.5, P=0.042) and previous appendicectomy (OR: 2.2; 95% CI: 1.3-3.8, P=0.003), and LC with UC (OR: 6.8; 95% CI: 1.7-28.0, P=0.008), thyroid disease (OR: 2.4; 95% CI: 1.1-5.4, P=0.037) and coeliac disease (OR: 8.7; 95% CI: 2.8-26.7, P<0.001).

    CONCLUSION: Association with a family history of microscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.

    sted, utgiver, år, opplag, sider
    Lippincott Williams & Wilkins, 2017
    Emneord
    inflammatory bowel diseases; microscopic colitis; risk factors; smoking
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-57572 (URN)10.1097/MEG.0000000000000832 (DOI)000398812100015 ()28350750 (PubMedID)2-s2.0-85016730155 (Scopus ID)
    Forskningsfinansiär
    Swedish Society of Medicine
    Merknad

    Other funding Agencies:

    Örebro University Hospital Research Foundation (Nyckelfonden)

    Bengt Ihre Foundation  22100-2009  98031-2010  176271-2011

    Örebro County Research Committee

    Tilgjengelig fra: 2017-05-04 Laget: 2017-05-04 Sist oppdatert: 2018-07-20bibliografisk kontrollert
    4. Microscopic colitis in patients with ulcerative colitis or Crohn’s disease: a retrospective observational study and review of the literature
    Åpne denne publikasjonen i ny fane eller vindu >>Microscopic colitis in patients with ulcerative colitis or Crohn’s disease: a retrospective observational study and review of the literature
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-57574 (URN)
    Tilgjengelig fra: 2017-05-04 Laget: 2017-05-04 Sist oppdatert: 2017-10-18bibliografisk kontrollert
  • 14.
    Wickbom, Anna
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Eriksson, Sune
    Dept Pathology, Örebro Univ Hosp, Örebro, Sweden.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Clin Epidemiol & Biostat Unit, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Tysk, Curt
    Örebro universitet, Hälsoakademin. Dept Gastroenterol, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Stable Incidence of Collagenous Colitis and Lymphocytic Colitis in Orebro, Sweden, 1999-2008: A Continuous Epidemiologic Study2013Inngår i: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 19, nr 11, s. 2387-2393Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The incidence of microscopic colitis (MC) has increased in several centers, but long-term epidemiologic data are missing. We report an epidemiologic study of collagenous colitis (CC) and lymphocytic colitis (LC) during 1999-2008, as a follow-up of our previous studies 1984-1998. Methods: Population-based study of residents of the catchment area of the hospital, with a new diagnosis of MC between 1999 and 2008. Patients were identified by diagnosis registers of the Departments of Medicine and Pathology. Medical files were reviewed, and colonic biopsies were reevaluated. Results: Collagenous colitis was diagnosed in 96 patients (75 females) and LC in 90 patients (74 females). The mean annual age-standardized incidence (per 100,000 inhabitants) was MC 10.2 (95% confidence interval: 8.7-11.7), CC 5.2 (4.2-6.3), and LC 5.0 (4.0-6.0). Age-specific incidence showed a peak in females older than 70 years. Prevalence (per 100,000 inhabitants) on December 31, 2008, was MC 123 (107.6-140.0), CC 67.7 (56.4-80.6), and LC 55.3 (45.2-67.1). A comparison of current study period with 1993-1998 showed unchanged mean incidence of MC, but a 2-fold increase in women older than 60 years with LC (standardized rate ratios 2.2, [1.2-3.7]) and increased female to male ratio (4.6:1 versus 2.1:1; P = 0.02) in LC. Conclusions: After an initial rise during 1980s and early 1990s, annual incidence of CC and LC has been stable during the last 15 years around 5/100,000 inhabitants for each disorder. The increasing incidence in older women with LC may be related to an increasing proportion of older individuals in the background population and increased colonoscopy frequency in elderly.

  • 15.
    Wickbom, Anna
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Bohr, Johan
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Eriksson, Anders
    Department of Medicine, Emergency and Geriatrics, Sahlgrenska University Hospital/East Hospital, Gothenburg, Sweden.
    Lapidus, Annika
    Department of Gastroenterology, Ersta Hospital, Stockholm, Sweden.
    Münch, Andreas
    Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Ung, Kjell-Arne
    Department of Internal Medicine, Sahlgrenska University Hospital/Mölndal, Gothenburg.
    Vigren, Lina
    Department of Medicine, Trelleborg Hospital, Trelleborg, Sweden.
    Tysk, Curt
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Microscopic colitis in patients with ulcerative colitis or Crohn’s disease: a retrospective observational study and review of the literatureManuskript (preprint) (Annet vitenskapelig)
  • 16.
    Wickbom, Anna
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bohr, Johan
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Eriksson, Anders
    Department of Medicine, Emergency and Geriatrics, Sahlgrenska University Hospital East, Gothenburg, Sweden.
    Lapidus, Annika
    Department of Gastroenterology, Ersta Hospital, Stockholm, Sweden.
    Münch, Andreas
    Department of Clinical and Experimental Medicine, Division of Gastroenterology and Hepatology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Ung, Kjell-Arne
    Department of Internal Medicine, Sahlgrenska University Hospital Mölndal, Gothenburg, Sweden.
    Vigren, Lina
    Department of Medicine, Trelleborg Hospital, Trelleborg, Sweden..
    Öst, Åke
    Department of Pathology and Cytology, Aleris Medilab, Täby, Sweden.
    Tysk, Curt
    Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Microscopic colitis in patients with ulcerative colitis or Crohn's disease: a retrospective observational study and review of the literature2018Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 53, nr 4, s. 410-416Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Onset of microscopic colitis (MC) in patients with ulcerative colitis (UC) or Crohn's disease (CD), or vice versa, has been reported occasionally but the subject is not well described. We therefore report a retrospective observational study of such patients and review the literature.

    METHODS: Forty-six Swedish gastroenterology clinics were contacted about patients with diagnoses of both inflammatory bowel disease (IBD) and MC. Publications were searched on PubMed.

    RESULTS: We identified 31 patients with onset of MC after a median (range) of 20 (2-52) years after diagnosis of IBD, or vice versa; 21 UC patients developed collagenous colitis (CC) (n = 16) or lymphocytic colitis (LC) (n = 5); nine CD patients developed CC (n = 5) or LC (n = 4); one CC patient developed CD. Of the 21 UC patients, 18 had extensive disease, whereas no consistent phenotype occurred in CD. Literature review revealed 27 comprehensive case reports of patients with diagnoses of both IBD and MC. Thirteen MC patients developed IBD, of which four required colectomy. Fourteen IBD patients later developed MC. There were incomplete clinical data in 115 additional reported patients.

    CONCLUSIONS: Altogether 173 patients with occurrence of both IBD and MC were found. The most common finding in our patients was onset of CC in a patient with UC. Although these are likely random associations of two different disorders, MC should be considered in the patient with UC or CD if there is onset of chronic watery diarrhoea without endoscopic relapse of IBD.

  • 17.
    Wickbom, Anna
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott M.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Bohr, Johan
    Region Örebro län. School of Medical Sciences, Örebro University, Örebro, Sweden; Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Tysk, Curt
    Region Örebro län. School of Medical Sciences, Örebro University, Örebro, Sweden; Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study2017Inngår i: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 29, nr 5, s. 587-594Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited.

    AIM: The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis.

    METHODS: A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality.

    RESULTS: Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, P<0.001) and LC (OR: 3.2; 95% CI: 1.6-6.7, P=0.002). The median age at diagnosis was around 10 years earlier in ever-smokers compared with never-smokers.CC was associated with a history of ulcerative colitis (UC) (OR: 8.7, 95% CI: 2.2-33.7, P=0.002), thyroid disease (OR: 2.3; 95% CI: 1.1-4.5, P=0.02), coeliac disease (OR: 13.1; 95% CI: 2.7-62.7, P=0.001), rheumatic disease (OR 1.9; 95% CI: 1.0-3.5, P=0.042) and previous appendicectomy (OR: 2.2; 95% CI: 1.3-3.8, P=0.003), and LC with UC (OR: 6.8; 95% CI: 1.7-28.0, P=0.008), thyroid disease (OR: 2.4; 95% CI: 1.1-5.4, P=0.037) and coeliac disease (OR: 8.7; 95% CI: 2.8-26.7, P<0.001).

    CONCLUSION: Association with a family history of microscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.

  • 18. Zhulina, Yaroslava
    et al.
    Hahn Strömberg, V.
    Shamikh, A.
    Gustavsson, A.
    Bohr, J.
    Nyhlin, N.
    Wickbom, Anna
    Bodin, L.
    Tysk, Curt
    Örebro universitet, Hälsoakademin.
    Carlson, M.
    Halfvarson, Jonas
    NFkB is activated in colonic mucosa of healthy co-twins to twins with inflammatory bowel disease2011Inngår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 60, nr Suppl 3, s. A290-A290Artikkel i tidsskrift (Fagfellevurdert)
  • 19. Zhulina, Yaroslava
    et al.
    Hahn Strömberg, Victoria
    Shamikh, A.
    Gustavsson, A.
    Bohr, J.
    Nyhlin, Nils
    Wickbom, A.
    Bodin, L.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Carlson, M.
    Halfvarson, Jonas
    Aktiverad NFkB i colonbiopsier hos tvillingar med inflammatorisk tarmsjukdom2012Inngår i: Gastrokuriren, ISSN 1651-0453, Vol. 17, nr 37, s. PO-27-PO-27Artikkel i tidsskrift (Annet vitenskapelig)
  • 20.
    Zhulina, Yaroslava
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Hahn-Strömberg, Victoria
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Pathology, Örebro University Hospital, Örebro, Sweden; Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Shamikh, Alia
    Department of Pathology, Örebro University Hospital, Örebro, Sweden; Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Peterson, Christer G. B.
    Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
    Gustavsson, Anders
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Nyhlin, Nils
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Wickbom, Anna
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Bohr, Johan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Bodin, Lennart
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Institute of Environmental Medicine, Unit of Intervention and Implementation Research, Karolinska Institute, Stockholm, Sweden.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Carlson, Marie
    Department of Medical Sciences, Gastroenterology Research Group, Uppsala University, Uppsala, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning. Department of Internal Medicine, Division of Gastroenterology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Subclinical Inflammation with Increased Neutrophil Activity in Healthy Twin Siblings Reflect Environmental Influence in the Pathogenesis of Inflammatory Bowel Disease2013Inngår i: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 19, nr 8, s. 1725-1731Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The mechanisms behind increased fecal calprotectin (FC) in healthy relatives of patients with inflammatory bowel disease (IBD) are unknown. Our aims were to explore if there is a subclinical inflammation with increased neutrophil activity in healthy twin siblings in discordant twin pairs with IBD and to assess the influence of genetics in this context.

    Methods: Nuclear factor kappa B (NF-B) and neutrophil activity, based on myeloperoxidase (MPO) and FC, were analyzed in healthy twin siblings in discordant twin pairs with IBD and compared with healthy controls. NF-B and MPO were assessed by immunohistochemistry and FC by enzyme-linked immunosorbent assay.

    Results: In total, 33 of 34 healthy twin siblings were histologically normal. Increased NF-B was more often observed in healthy twin siblings in discordant twin pairs with Crohn's disease (13/18 [73%]) and with ulcerative colitis (12/16 [75%]) than in healthy controls (8/45 [18%]). MPO was more often increased in healthy twin siblings in discordant pairs with Crohn's disease (12/18 [67%]) than in healthy controls (11/45 [24%]) and FC more often in healthy twin siblings in discordant pairs with ulcerative colitis (14/21 [67%]) than in healthy controls (6/31 [19%]). Interestingly, the observed differences remained when healthy monozygotic and dizygotic twin siblings were analyzed separately.

    Conclusions:We observed increased NF-B, MPO, and FC in healthy twins in both monozygotic and dizygotic discordant pairs with IBD. These novel findings speak for an ongoing subclinical inflammation with increased neutrophil activity in healthy first-degree relatives.

  • 21. Zhulina, Yaroslava
    et al.
    Lindberg, E.
    Sjöberg, Mats
    Nyhlin, Nils
    Wickbom, Anna
    Eriksson, C
    Johansson, I.
    van Nieuwenhoven, Michiel A.
    Salén, E.
    Curman, B.
    Yimam, Y.
    Brummer, Robert
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Bohr, J.
    Tysk, Curt
    Örebro universitet, Hälsoakademin.
    Halfvarson, Jonas
    Inflammatorisk tarmsjukdom i Örebro 2010: en epidemiologisk uppdatering2011Inngår i: Gastrokuriren, ISSN 1651-0453, Vol. 16, nr 29, s. PO-10-PO-10Artikkel i tidsskrift (Annet vitenskapelig)
1 - 21 of 21
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