Hironao Takahashi

Enteral nutrition decreases hospitalization rate in patients with Crohn's disease

Background and Aims:  Crohns disease (CD) is a chronic inflammatory bowel disease with relapse and remission. CD patients are admitted to hospital when bowel inflammation flares up severely, which lowers their quality of life. Enteral nutrition (EN) with an elemental diet plays an important role in the treatment for CD patients in Japan, because of its few adverse effects, and it is thought to be effective in maintaining remission. We investigated the effectiveness of EN with an elemental diet with regard to the avoidance of hospitalization.

Changes in biochemical parameters related to atherosclerosis after Helicobacter pylori eradication: HELICOBACTER PYLORI ERADICATION AND ATHEROSCLEROSIS

Recent evidence suggests that Helicobacter pylori infection is involved in the pathogenesis of extra‐gastrointestinal diseases such as coronary heart disease.

Usefulness of an elemental diet in Crohn’s disease

Abstract.Crohn’s disease is a chronic relapsing disease for which no complete cure is available. Although drug therapy with agents such as corticosteroids and azathiopurine is useful, the long-term side effects of these drugs are problematic. The advent of infliximab has recently brought a change in treatment, but the long-term side effects of this agent remain uncertain. In contrast, nutritional therapy produces no druginduced side effects and is effective in inducing and maintaining remission. However, sufficient efficacy cannot be expected in patients in whom compliance with nutritional regimens gradually decreases owing to unpalatability. In these cases, combination therapy with agents such as immunosuppressors and infliximab may be useful.

Infliximab regulates lamina propria T lymphocytes in patients with Crohn's disease: INFLIXIMAB AND CROHN'S DISEASE

The immune system is a major determinant of the pathophysiological inflammation, which may lead to gastrointestinal mucosal injury in patients with Crohns disease. Cytokines such as tumour necrosis factor‐alpha are well‐known mediators of the immune system, and treatment with a chimeric anti‐tumour necrosis factor‐alpha antibody (infliximab) has been shown to be highly effective in patients with Crohns disease. Recent evidence indicates that infliximab induces apoptosis in lamina propria T lymphocytes in these patients. To better understand the mechanisms of infliximabs effect on gastrointestinal inflammation, we investigated changes in the serum level of cytokines after treatment in these patients, and the effect of infliximab in inducing the apoptosis of T lymphocytes.