Skip to main content
Erschienen in: Journal of Gastroenterology 9/2012

01.09.2012 | Original Article—Alimentary Tract

Anti-high mobility group box 1 and box 2 non-histone chromosomal proteins (HMGB1/HMGB2) antibodies and anti-Saccharomyces cerevisiae antibodies (ASCA): accuracy in differentially diagnosing UC and CD and correlation with inflammatory bowel disease phenotype

verfasst von: Hiromasa Takaishi, Takanori Kanai, Atsushi Nakazawa, Fumihiko Sugata, Akira Nikai, Shigeo Yoshizawa, Yasuo Hamamoto, Shinsuke Funakoshi, Tomoharu Yajima, Yasushi Iwao, Masao Takemura, Shoichi Ozaki, Toshifumi Hibi

Erschienen in: Journal of Gastroenterology | Ausgabe 9/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The development of a supportive diagnostic method has long been required to differentially diagnose ulcerative colitis (UC) and Crohn’s disease (CD). Several antibodies circulate in the sera of patients with inflammatory bowel disease. We previously identified the high mobility group box 1 and box 2 non-histone chromosomal proteins (HMGB1 and HMGB2) as novel antigens of perinuclear type anti-neutrophil cytoplasmic antibodies (pANCA) and discovered anti-HMGB1/HMGB2 antibodies in sera from patients with UC. Here, we evaluated the ability of anti-HMGB1/HMGB2 antibodies combined with anti-Saccharomyces cerevisiae antibodies (ASCA) to differentially diagnose UC and CD.

Methods

We measured titers of anti-HMGB1/HMGB2 antibodies and ASCA in the sera of 213 patients with UC and 93 with CD, using enzyme-linked immunosorbent assays.

Results

Among the patients with UC, 26.8% were positive for anti-HMGB1/HMGB2 antibodies, with 85.0% specificity towards CD and a positive predictive value of 80.3%. Corticosteroids significantly suppressed the titer of anti-HMGB1/HMGB2 antibodies. Among the patients with CD, 24.7% were positive for ASCA, with 96.2% specificity towards UC and a positive predictive value of 74.2%. Interestingly, the positivity rate of anti-HMGB/HMGB2 antibodies was higher (35.7%) in patients with the ileitis type of CD than in patients with CD in the colon (6.2%; significant difference, P < 0.01). The specificity of anti-HMGB1/HMGB2 antibodies in UC for CD in the colon was 93.8%.

Conclusions

CD in the colon and UC can be differentially diagnosed using anti-HMGB/HMGB2 antibodies combined with ASCA.
Literatur
1.
Zurück zum Zitat Hibi T, Ohara M, Kobayashi K, Brown WR, Toda K, Takaishi H, et al. Enzyme linked immunosorbent assay (ELISA) and immunoprecipitation studies on anti-goblet cell antibody using a mucin producing cell line in patients with inflammatory bowel disease. Gut. 1994;35:224–30.PubMedCrossRef Hibi T, Ohara M, Kobayashi K, Brown WR, Toda K, Takaishi H, et al. Enzyme linked immunosorbent assay (ELISA) and immunoprecipitation studies on anti-goblet cell antibody using a mucin producing cell line in patients with inflammatory bowel disease. Gut. 1994;35:224–30.PubMedCrossRef
2.
Zurück zum Zitat Takaishi H, Ohara S, Hotta K, Yajima T, Kanai T, Inoue N, et al. Circulating autoantibodies against purified colonic mucin in ulcerative colitis. J Gastroenterol. 2000;35:20–7.PubMedCrossRef Takaishi H, Ohara S, Hotta K, Yajima T, Kanai T, Inoue N, et al. Circulating autoantibodies against purified colonic mucin in ulcerative colitis. J Gastroenterol. 2000;35:20–7.PubMedCrossRef
3.
Zurück zum Zitat Das KM, Dasgupta A, Mandal A, Geng X. Autoimmunity to cytoskeletal protein tropomyosin. A clue to the pathogenetic mechanism for ulcerative colitis. J Immunol. 1993;150:2487–93.PubMed Das KM, Dasgupta A, Mandal A, Geng X. Autoimmunity to cytoskeletal protein tropomyosin. A clue to the pathogenetic mechanism for ulcerative colitis. J Immunol. 1993;150:2487–93.PubMed
4.
Zurück zum Zitat Duerr RH, Targan SR, Landers CJ, Sutherland LR, Shanahan F. Anti-neutrophil cytoplasmic antibodies in ulcerative colitis. Comparison with other colitides/diarrheal illnesses. Gastroenterology. 1991;100:1590–6.PubMed Duerr RH, Targan SR, Landers CJ, Sutherland LR, Shanahan F. Anti-neutrophil cytoplasmic antibodies in ulcerative colitis. Comparison with other colitides/diarrheal illnesses. Gastroenterology. 1991;100:1590–6.PubMed
5.
Zurück zum Zitat Lassoued S, Sixou L, Oksman F, Pages M, Fournie A. Antineutrophil cytoplasmic antibodies and antibodies to myeloperoxidase in rheumatoid arthritis. Arthritis Rheum. 1991;34:1069–70.PubMedCrossRef Lassoued S, Sixou L, Oksman F, Pages M, Fournie A. Antineutrophil cytoplasmic antibodies and antibodies to myeloperoxidase in rheumatoid arthritis. Arthritis Rheum. 1991;34:1069–70.PubMedCrossRef
6.
Zurück zum Zitat Halbwachs-Mecarelli L, Nusbaum P, Noel LH, Reumaux D, Erlinger S, Grunfeld JP, et al. Antineutrophil cytoplasmic antibodies (ANCA) directed against cathepsin G in ulcerative colitis, Crohn’s disease and primary sclerosing cholangitis. Clin Exp Immunol. 1992;90:79–84.PubMedCrossRef Halbwachs-Mecarelli L, Nusbaum P, Noel LH, Reumaux D, Erlinger S, Grunfeld JP, et al. Antineutrophil cytoplasmic antibodies (ANCA) directed against cathepsin G in ulcerative colitis, Crohn’s disease and primary sclerosing cholangitis. Clin Exp Immunol. 1992;90:79–84.PubMedCrossRef
7.
Zurück zum Zitat Goldschmeding R, van der Schoot CE, ten Bokkel Huinink D, Hack CE, van den Ende ME, Kallenberg CG, et al. Wegener’s granulomatosis autoantibodies identify a novel diisopropylfluorophosphate-binding protein in the lysosomes of normal human neutrophils. J Clin Invest. 1989;84:1577–87.PubMedCrossRef Goldschmeding R, van der Schoot CE, ten Bokkel Huinink D, Hack CE, van den Ende ME, Kallenberg CG, et al. Wegener’s granulomatosis autoantibodies identify a novel diisopropylfluorophosphate-binding protein in the lysosomes of normal human neutrophils. J Clin Invest. 1989;84:1577–87.PubMedCrossRef
8.
Zurück zum Zitat Sobajima J, Ozaki S, Osakada F, Uesugi H, Shirakawa H, Yoshida M, et al. Novel autoantigens of perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) in ulcerative colitis: non-histone chromosomal proteins, HMG1 and HMG2. Clin Exp Immunol. 1997;107:135–40.PubMedCrossRef Sobajima J, Ozaki S, Osakada F, Uesugi H, Shirakawa H, Yoshida M, et al. Novel autoantigens of perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) in ulcerative colitis: non-histone chromosomal proteins, HMG1 and HMG2. Clin Exp Immunol. 1997;107:135–40.PubMedCrossRef
9.
Zurück zum Zitat Lotze MT, Tracey KJ. High-mobility group box 1 protein (HMGB1): nuclear weapon in the immune arsenal. Nat Rev Immunol. 2005;5:331–42.PubMedCrossRef Lotze MT, Tracey KJ. High-mobility group box 1 protein (HMGB1): nuclear weapon in the immune arsenal. Nat Rev Immunol. 2005;5:331–42.PubMedCrossRef
10.
Zurück zum Zitat Muller S, Ronfani L, Bianchi ME. Regulated expression and subcellular localization of HMGB1, a chromatin protein with a cytokine function. J Intern Med. 2004;255:332–43.PubMedCrossRef Muller S, Ronfani L, Bianchi ME. Regulated expression and subcellular localization of HMGB1, a chromatin protein with a cytokine function. J Intern Med. 2004;255:332–43.PubMedCrossRef
11.
Zurück zum Zitat Waga S, Mizuno S, Yoshida M. Chromosomal protein HMG1 removes the transcriptional block caused by the cruciform in supercoiled DNA. J Biol Chem. 1990;265:19424–8.PubMed Waga S, Mizuno S, Yoshida M. Chromosomal protein HMG1 removes the transcriptional block caused by the cruciform in supercoiled DNA. J Biol Chem. 1990;265:19424–8.PubMed
12.
Zurück zum Zitat Shirakawa H, Tsuda K, Yoshida M. Primary structure of non-histone chromosomal protein HMG2 revealed by the nucleotide sequence. Biochemistry. 1990;29:4419–23.PubMedCrossRef Shirakawa H, Tsuda K, Yoshida M. Primary structure of non-histone chromosomal protein HMG2 revealed by the nucleotide sequence. Biochemistry. 1990;29:4419–23.PubMedCrossRef
13.
Zurück zum Zitat Melloni E, Sparatore B, Patrone M, Pessino A, Passalacqua M, Pontremoli S. Extracellular release of the ‘differentiation enhancing factor’, a HMG1 protein type, is an early step in murine erythroleukemia cell differentiation. FEBS Lett. 1995;368:466–70.PubMedCrossRef Melloni E, Sparatore B, Patrone M, Pessino A, Passalacqua M, Pontremoli S. Extracellular release of the ‘differentiation enhancing factor’, a HMG1 protein type, is an early step in murine erythroleukemia cell differentiation. FEBS Lett. 1995;368:466–70.PubMedCrossRef
14.
Zurück zum Zitat Passalacqua M, Zicca A, Sparatore B, Patrone M, Melloni E, Pontremoli S. Secretion and binding of HMG1 protein to the external surface of the membrane are required for murine erythroleukemia cell differentiation. FEBS Lett. 1997;400:275–9.PubMedCrossRef Passalacqua M, Zicca A, Sparatore B, Patrone M, Melloni E, Pontremoli S. Secretion and binding of HMG1 protein to the external surface of the membrane are required for murine erythroleukemia cell differentiation. FEBS Lett. 1997;400:275–9.PubMedCrossRef
15.
Zurück zum Zitat Weir HM, Kraulis PJ, Hill CS, Raine AR, Laue ED, Thomas JO. Structure of the HMG box motif in the B-domain of HMG1. EMBO J. 1993;12:1311–9.PubMed Weir HM, Kraulis PJ, Hill CS, Raine AR, Laue ED, Thomas JO. Structure of the HMG box motif in the B-domain of HMG1. EMBO J. 1993;12:1311–9.PubMed
16.
Zurück zum Zitat Sobajima J, Ozaki S, Uesugi H, Osakada F, Inoue M, Fukuda Y, et al. High mobility group (HMG) non-histone chromosomal proteins HMG1 and HMG2 are significant target antigens of perinuclear anti-neutrophil cytoplasmic antibodies in autoimmune hepatitis. Gut. 1999;44:867–73.PubMedCrossRef Sobajima J, Ozaki S, Uesugi H, Osakada F, Inoue M, Fukuda Y, et al. High mobility group (HMG) non-histone chromosomal proteins HMG1 and HMG2 are significant target antigens of perinuclear anti-neutrophil cytoplasmic antibodies in autoimmune hepatitis. Gut. 1999;44:867–73.PubMedCrossRef
17.
Zurück zum Zitat Andersson U, Erlandsson-Harris H. HMGB1 is a potent trigger of arthritis. J Intern Med. 2004;255:344–50.PubMedCrossRef Andersson U, Erlandsson-Harris H. HMGB1 is a potent trigger of arthritis. J Intern Med. 2004;255:344–50.PubMedCrossRef
18.
Zurück zum Zitat Uesugi H, Ozaki S, Sobajima J, Osakada F, Shirakawa H, Yoshida M, et al. Prevalence and characterization of novel pANCA, antibodies to the high mobility group non-histone chromosomal proteins HMG1 and HMG2, in systemic rheumatic diseases. J Rheumatol. 1998;25:703–9.PubMed Uesugi H, Ozaki S, Sobajima J, Osakada F, Shirakawa H, Yoshida M, et al. Prevalence and characterization of novel pANCA, antibodies to the high mobility group non-histone chromosomal proteins HMG1 and HMG2, in systemic rheumatic diseases. J Rheumatol. 1998;25:703–9.PubMed
19.
Zurück zum Zitat Sobajima J, Ozaki S, Uesugi H, Osakada F, Shirakawa H, Yoshida M, et al. Prevalence and characterization of perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) directed against HMG1 and HMG2 in ulcerative colitis (UC). Clin Exp Immunol. 1998;111:402–7.PubMedCrossRef Sobajima J, Ozaki S, Uesugi H, Osakada F, Shirakawa H, Yoshida M, et al. Prevalence and characterization of perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) directed against HMG1 and HMG2 in ulcerative colitis (UC). Clin Exp Immunol. 1998;111:402–7.PubMedCrossRef
20.
Zurück zum Zitat Sonnenberg A. Occupational mortality of inflammatory bowel disease. Digestion. 1990;46:10–8.PubMedCrossRef Sonnenberg A. Occupational mortality of inflammatory bowel disease. Digestion. 1990;46:10–8.PubMedCrossRef
21.
Zurück zum Zitat Main J, McKenzie H, Yeaman GR, Kerr MA, Robson D, Pennington CR, et al. Antibody to Saccharomyces cerevisiae (bakers’ yeast) in Crohn’s disease. BMJ. 1988;297:1105–6.PubMedCrossRef Main J, McKenzie H, Yeaman GR, Kerr MA, Robson D, Pennington CR, et al. Antibody to Saccharomyces cerevisiae (bakers’ yeast) in Crohn’s disease. BMJ. 1988;297:1105–6.PubMedCrossRef
22.
Zurück zum Zitat Sendid B, Colombel JF, Jacquinot PM, Faille C, Fruit J, Cortot A, et al. Specific antibody response to oligomannosidic epitopes in Crohn’s disease. Clin Diagn Lab Immunol. 1996;3:219–26.PubMed Sendid B, Colombel JF, Jacquinot PM, Faille C, Fruit J, Cortot A, et al. Specific antibody response to oligomannosidic epitopes in Crohn’s disease. Clin Diagn Lab Immunol. 1996;3:219–26.PubMed
23.
Zurück zum Zitat Joossens S, Reinisch W, Vermeire S, Sendid B, Poulain D, Peeters M, Geboes K, Bossuyt X, Vandewalle P, Oberhuber G, Vogelsang H, Rutgeerts P, Colombel JF. The value of serologic markers in indeterminate colitis: a prospective follow-up study. Gastroenterology. 2002;122:1242–7.PubMedCrossRef Joossens S, Reinisch W, Vermeire S, Sendid B, Poulain D, Peeters M, Geboes K, Bossuyt X, Vandewalle P, Oberhuber G, Vogelsang H, Rutgeerts P, Colombel JF. The value of serologic markers in indeterminate colitis: a prospective follow-up study. Gastroenterology. 2002;122:1242–7.PubMedCrossRef
24.
Zurück zum Zitat Quinton JF, Sendid B, Reumaux D, Duthilleul P, Cortot A, Grandbastien B, et al. Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut. 1998;42:788–91.PubMedCrossRef Quinton JF, Sendid B, Reumaux D, Duthilleul P, Cortot A, Grandbastien B, et al. Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut. 1998;42:788–91.PubMedCrossRef
25.
Zurück zum Zitat Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl. 1989;170:2–6. (discussion 16–9).PubMedCrossRef Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl. 1989;170:2–6. (discussion 16–9).PubMedCrossRef
26.
Zurück zum Zitat Marion JF, Rubin PH, Present DH. Differential diagnosis of chronic ulcerative colitis and Crohn’s disease. In: Kirsner JB, editor. Inflammatory bowel disease. 5th ed. Philadelphia: WB Sauders; 2000. Marion JF, Rubin PH, Present DH. Differential diagnosis of chronic ulcerative colitis and Crohn’s disease. In: Kirsner JB, editor. Inflammatory bowel disease. 5th ed. Philadelphia: WB Sauders; 2000.
27.
Zurück zum Zitat Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med. 1994;330:1841–5.PubMedCrossRef Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med. 1994;330:1841–5.PubMedCrossRef
28.
Zurück zum Zitat Winship DH, Summers RW, Singleton JW, Best WR, Becktel JM, Lenk LF, et al. National Cooperative Crohn’s Disease Study: study design and conduct of the study. Gastroenterology. 1979;77:829–42.PubMed Winship DH, Summers RW, Singleton JW, Best WR, Becktel JM, Lenk LF, et al. National Cooperative Crohn’s Disease Study: study design and conduct of the study. Gastroenterology. 1979;77:829–42.PubMed
29.
Zurück zum Zitat Wiik A. Delineation of a standard procedure for indirect immunofluorescence detection of ANCA. APMIS Suppl. 1989;6:12–3.PubMed Wiik A. Delineation of a standard procedure for indirect immunofluorescence detection of ANCA. APMIS Suppl. 1989;6:12–3.PubMed
30.
Zurück zum Zitat Charles LA, Falk RJ, Jennette JC. Reactivity of antineutrophil cytoplasmic autoantibodies with mononuclear phagocytes. J Leukoc Biol. 1992;51:65–8.PubMed Charles LA, Falk RJ, Jennette JC. Reactivity of antineutrophil cytoplasmic autoantibodies with mononuclear phagocytes. J Leukoc Biol. 1992;51:65–8.PubMed
31.
Zurück zum Zitat Barclay GR, McKenzie H, Pennington J, Parratt D, Pennington CR. The effect of dietary yeast on the activity of stable chronic Crohn’s disease. Scand J Gastroenterol. 1992;27:196–200.PubMedCrossRef Barclay GR, McKenzie H, Pennington J, Parratt D, Pennington CR. The effect of dietary yeast on the activity of stable chronic Crohn’s disease. Scand J Gastroenterol. 1992;27:196–200.PubMedCrossRef
32.
Zurück zum Zitat Hisabe T, Matsui T, Sakurai T, Murakami Y, Tanabe H, Matake H, et al. Anti-Saccharomyces cerevisiae antibodies in Japanese patients with inflammatory bowel disease: diagnostic accuracy and clinical value. J Gastroenterol. 2003;38:121–6.PubMedCrossRef Hisabe T, Matsui T, Sakurai T, Murakami Y, Tanabe H, Matake H, et al. Anti-Saccharomyces cerevisiae antibodies in Japanese patients with inflammatory bowel disease: diagnostic accuracy and clinical value. J Gastroenterol. 2003;38:121–6.PubMedCrossRef
33.
Zurück zum Zitat Sugi K, Saitoh O, Matsuse R, Tabata K, Uchida K, Kojima K, et al. Antineutrophil cytoplasmic antibodies in Japanese patients with inflammatory bowel disease: prevalence and recognition of putative antigens. Am J Gastroenterol. 1999;94:1304–12.PubMedCrossRef Sugi K, Saitoh O, Matsuse R, Tabata K, Uchida K, Kojima K, et al. Antineutrophil cytoplasmic antibodies in Japanese patients with inflammatory bowel disease: prevalence and recognition of putative antigens. Am J Gastroenterol. 1999;94:1304–12.PubMedCrossRef
34.
Zurück zum Zitat Giaffer MH, Clark A, Holdsworth CD. Antibodies to Saccharomyces cerevisiae in patients with Crohn’s disease and their possible pathogenic importance. Gut. 1992;33:1071–5.PubMedCrossRef Giaffer MH, Clark A, Holdsworth CD. Antibodies to Saccharomyces cerevisiae in patients with Crohn’s disease and their possible pathogenic importance. Gut. 1992;33:1071–5.PubMedCrossRef
35.
Zurück zum Zitat Standaert-Vitse A, Jouault T, Vandewalle P, Mille C, Seddik M, Sendid B, et al. Candida albicans is an immunogen for anti-Saccharomyces cerevisiae antibody markers of Crohn’s disease. Gastroenterology. 2006;130:1764–75.PubMedCrossRef Standaert-Vitse A, Jouault T, Vandewalle P, Mille C, Seddik M, Sendid B, et al. Candida albicans is an immunogen for anti-Saccharomyces cerevisiae antibody markers of Crohn’s disease. Gastroenterology. 2006;130:1764–75.PubMedCrossRef
36.
Zurück zum Zitat Oshitani N, Hato F, Matsumoto T, Jinno Y, Sawa Y, Hara J, et al. Decreased anti-Saccharomyces cerevisiae antibody titer by mesalazine in patients with Crohn’s disease. J Gastroenterol Hepatol. 2000;15:1400–3.PubMedCrossRef Oshitani N, Hato F, Matsumoto T, Jinno Y, Sawa Y, Hara J, et al. Decreased anti-Saccharomyces cerevisiae antibody titer by mesalazine in patients with Crohn’s disease. J Gastroenterol Hepatol. 2000;15:1400–3.PubMedCrossRef
37.
Zurück zum Zitat Israeli E, Grotto I, Gilburd B, Balicer RD, Goldin E, Wiik A, et al. Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease. Gut. 2005;54:1232–6.PubMedCrossRef Israeli E, Grotto I, Gilburd B, Balicer RD, Goldin E, Wiik A, et al. Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease. Gut. 2005;54:1232–6.PubMedCrossRef
38.
Zurück zum Zitat Cohavy O, Bruckner D, Gordon LK, Misra R, Wei B, Eggena ME, et al. Colonic bacteria express an ulcerative colitis pANCA-related protein epitope. Infect Immun. 2000;68:1542–8.PubMedCrossRef Cohavy O, Bruckner D, Gordon LK, Misra R, Wei B, Eggena ME, et al. Colonic bacteria express an ulcerative colitis pANCA-related protein epitope. Infect Immun. 2000;68:1542–8.PubMedCrossRef
39.
Zurück zum Zitat Fleshner PR, Vasiliauskas EA, Kam LY, Fleshner NE, Gaiennie J, Abreu-Martin MT, et al. High level perinuclear antineutrophil cytoplasmic antibody (pANCA) in ulcerative colitis patients before colectomy predicts the development of chronic pouchitis after ileal pouch-anal anastomosis. Gut. 2001;49:671–7.PubMedCrossRef Fleshner PR, Vasiliauskas EA, Kam LY, Fleshner NE, Gaiennie J, Abreu-Martin MT, et al. High level perinuclear antineutrophil cytoplasmic antibody (pANCA) in ulcerative colitis patients before colectomy predicts the development of chronic pouchitis after ileal pouch-anal anastomosis. Gut. 2001;49:671–7.PubMedCrossRef
Metadaten
Titel
Anti-high mobility group box 1 and box 2 non-histone chromosomal proteins (HMGB1/HMGB2) antibodies and anti-Saccharomyces cerevisiae antibodies (ASCA): accuracy in differentially diagnosing UC and CD and correlation with inflammatory bowel disease phenotype
verfasst von
Hiromasa Takaishi
Takanori Kanai
Atsushi Nakazawa
Fumihiko Sugata
Akira Nikai
Shigeo Yoshizawa
Yasuo Hamamoto
Shinsuke Funakoshi
Tomoharu Yajima
Yasushi Iwao
Masao Takemura
Shoichi Ozaki
Toshifumi Hibi
Publikationsdatum
01.09.2012
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 9/2012
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-012-0566-3

Weitere Artikel der Ausgabe 9/2012

Journal of Gastroenterology 9/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.