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- Title
Influence of Topically and Systemically Active Steroids on Circulating Leukocytes in Crohn's Disease.
- Authors
Tillinger, W.; Gasche, C.; Reinisch, W.; Lichtenberger, C.; Bakos, S.; Dejaco, C.; Moser, G.; Vogelsang, H.; Gangl, A.; Lochs, H.
- Abstract
Objective: Budesonide, although only topically active, is effective in the treatment of Crohn's disease. This study was performed to compare the clinical efficacies of budesonide and prednisolone in relation to the activation status of circulating leukocytes. Methods: Twenty-four patients with active Crohn's disease were randomized to treatment with either budesonide or 6-methylprednisolone. Clinical response was monitored by the Crohn's disease activity index, C-reactive protein, and orosomucoid. Expression of CD25 and CD71 on T cells and CD64 on neutrophils was determined by flow cytometry. The release of TNF-α and IL-1β by peripheral blood mononuclear cells was measured by ELISA. Results: After 2 wk of treatment a clinical response was observed in both groups, but it was more accentuated in patients treated with prednisolone. At baseline an up-regulation of CD71 and CD64, but not CD25, was found in active patients. Prednisolone significantly decreased the expression of CD64 and the release of TNF-α and IL-1β, but did not alter the expression of CD25 and CD71. Budesonide treatment failed to exert any effect on circulating leukocytes. Conclusions: The inability of budesonide to downregulate activated circulating leukocytes may contribute to the somewhat lower clinical efficacy of this topical steroid in the treatment of active Crohn's disease.
- Subjects
CROHN'S disease; LEUCOCYTES; C-reactive protein; NEUTROPHILS; FLOW cytometry
- Publication
American Journal of Gastroenterology (Springer Nature), 1998, Vol 93, Issue 10, p1848
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.1998.536_e.x