Share Facebook
Crohn's Disease Forum » Books, Multimedia, Research & News » Bacterial DNA linked to short-term Crohn's disease flare


03-09-2016, 07:46 PM   #1
irishgal
Senior Member
 
irishgal's Avatar
 
Join Date: May 2015

My Support Groups:
Bacterial DNA linked to short-term Crohn's disease flare

Found this new study. Looks like patients with BactDNA don't fare so well:
http://www.nature.com/ajg/journal/va...ajg20168a.html

OBJECTIVES:

We aimed at evaluating bacterial DNA (bactDNA) presence in blood of Crohn’s disease (CD) patients in remission as an independent risk factor of flare at 6 months.

METHODS:

This is a prospective, multicenter study on CD patients with Crohn’s disease activity index (CDAI)<150. The primary end point was time-to-relapse as evaluated by CDAI>150 in the following 6 months. BactDNA in blood, the nucleotide-binding oligomerization domain containing 2 (NOD2) genotype, and serum cytokine levels were determined at baseline.

RESULTS:

A total of 288 patients were included. BactDNA was detected in 98 patients (34.0%). A variant-NOD2 genotype was identified in 114 patients (39.6%). Forty patients (14%) relapsed during follow-up. Multivariate survival analysis identified bactDNA as an independent risk factor of flare (hazard ratio (HR) 8.75 (4.02–19.06) 95% confidence interval (CI)). Hospitalization, surgery, switch of treatment, initiation and escalation of anti-tumor necrosis factor (TNF) therapy, steroids initiation, and increased fecal calprotectin levels at 6 months were associated with bactDNA at baseline. A logistic regression analysis showed bactDNA as an independent and significant predictive factor of hospitalization (odds ratio (OR) 11.9 (3.4–42.3); P<0.001), steroids startup (OR 8.5 (2.7–27.1); P<0.001), and switch of treatment (OR 3.5 (1.6–7.7); P=0.002) at 6 months. No relationship was observed between bactDNA and mucosal lesions in patients with colonoscopy at admission. Serum pro-inflammatory cytokines were significantly increased in patients with bactDNA or a variant-NOD2 genotype. The combination of both factors induced decreased anti-TNF-α levels and a higher percentage of patients on intensified anti-TNF therapy.

CONCLUSIONS:

BactDNA is an independent risk factor of relapse at 6 months in CD patients. BactDNA is also independently associated with an increased risk of hospitalization, switch of treatment, and steroids initiation.
__________________
Currently on: Anti-MAP therapy and loving life! Full remission since Jan 2015. Clarithromycin, rifampin and low dose naltrexone. (Levofloxicin had too many side effects so discontinued after 5 months.) Resources on human MAP and Crohn's here: HumanPara.org.

Past (failed) Treatments: Remicade, Humira, Prednisone, Pentasa, Azulfadine, Lialda, No gluten/dairy/sugar/coffee or processed food in general. Flagyl worked but not long term.
Reply

Crohn's Disease Forum » Books, Multimedia, Research & News » Bacterial DNA linked to short-term Crohn's disease flare
Thread Tools


All times are GMT -5. The time now is 11:44 PM.
Copyright 2006-2017 Crohnsforum.com