title: Infliximab preferentially induces clinical remission and mucosal healing in short course Crohn's disease with luminal lesions through balancing abnormal immune response in gut mucosa.
abstract: This study was undertaken to evaluate the efficacy of infliximab (IFX) in treatment of Crohn's disease (CD) patients. 106 CD patients were undergoing treatment with IFX from five hospitals in Shanghai, China. Clinical remission to IFX induction therapy was defined as Crohn's disease activity index (CDAI) < 150. Clinical response was assessed by a decrease in CDAI ≥ 70, and the failure as a CDAI was not significantly changed or increased. Ten weeks after therapy, 61 (57.5%) patients achieved clinical remission, 17 (16.0%) had clinical response, and the remaining 28 (26.4%) were failed. In remission group, significant changes were observed in CDAI, the Simple Endoscopic Score for Crohn's Disease (SES-CD), and serum indexes. Patients with short disease duration (22.2 ± 23.2 months) and luminal lesions showed better effects compared to those with long disease duration (71.0 ± 58.2 months) or stricturing and penetrating lesions. IFX markedly downregulated Th1/Th17-mediated immune response but promoted IL-25 production in intestinal mucosa from remission group. No serious adverse events occurred to terminate treatment. Taken together, our studies demonstrated that IFX is efficacious and safe in inducing clinical remission, promoting mucosal healing, and downregulating Th1/Th17-mediated immune response in short course CD patients with luminal lesions.
authors: Department of Gastroenterology, The Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China.
authors: Lijuan
authors: L
authors: Yu
authors: Department of Gastroenterology, The Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China.
authors: Xuehua
authors: X
authors: Yang
authors: Department of Gastroenterology, Ruijin Hospital of Shanghai Jiaotong University, Shanghai 200025, China.
authors: Lu
authors: L
authors: Xia
authors: Department of Gastroenterology, Ruijin Hospital of Shanghai Jiaotong University, Shanghai 200025, China.
authors: Jie
authors: J
authors: Zhong
authors: Department of Gastroenterology, Xinhua Hospital of Shanghai Jiaotong University, Shanghai 200092, China.
authors: Wensong
authors: W
authors: Ge
authors: Department of Gastroenterology, Xinhua Hospital of Shanghai Jiaotong University, Shanghai 200092, China.
authors: Jianxin
authors: J
authors: Wu
authors: Department of Gastroenterology, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
authors: Hongchun
authors: H
authors: Liu
authors: Department of Gastroenterology, East Hospital of Tongji University, Shanghai 200120, China.
authors: Fei
authors: F
authors: Liu
authors: Department of Gastroenterology, The Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China.
authors: Zhanju
authors: Z
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000188:drug therapy* / Q000276:immunology; D016207:Cytokines / Q000235:genetics; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000009:adverse effects / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis
chemical_list: D016207:Cytokines; D012333:RNA, Messenger; D000069285:Infliximab