Pouchitis
Pouchitis is the most common long-term complication of ileal pouch-anal anastomosis (IPAA) and is a syndrome that includes many different diseases. Chronic antibiotic refractory pouchitis (CARP) is a significant challenge in the therapeutic of pouchitis. Our company is a pioneer in the development of innovative therapeutic platforms for rare diseases, which can help you enhance the research and development efforts in the field of pouchitis diagnosis and therapeutic.
Introduction to Pouchitis
Pouchitis is a complication that can occur in individuals who have undergone surgery to create an IPAA. This surgical procedure is often performed as a therapeutic for ulcerative colitis or familial adenomatous polyposis, where the colon and rectum are removed and a pouch is created from the end of the small intestine to serve as a reservoir for stool (Fig.1). Pouchitis is characterized by inflammation of the ileal pouch, which can cause symptoms such as increased frequency of bowel movements, urgency to defecate, abdominal cramping, and sometimes bloody diarrhea.
Fig.1 Schema of the J pouch. (Akiyama, S., et al., 2021)Pathogenesis of Pouchitis
The pathogenesis of pouchitis is multifactorial and is believed to involve a combination of genetic, environmental, and microbial factors. Following surgery to create an IPAA, there are significant changes in the composition and diversity of the gut microbiome. These changes can disrupt the balance of beneficial bacteria and harmful pathogens in the gut, leading to dysbiosis and damage to the intestinal mucosa (Fig.2). Certain genetic variations in immune system genes or genes that regulate gut barrier function may increase the risk of developing pouchitis.
Fig.2 The role of the gut microbiome. (LeBlanc, J. F., et al., 2021)Diagnostics Development of Pouchitis
- Imaging Diagnostic Technologies
Imaging techniques such as computed tomography enterography (CTE), magnetic resonance enterography (MRE), and magnetic resonance imaging (MRI) can provide detailed information about the condition of the pouch, inflammation, and other abnormalities.
- Molecular Diagnostic Technologies
Detection of specific genes (NOD2/CARD15) using sequencing techniques such as next-generation sequencing (NGS) or determination of biomarkers (pANC and ASCA) using immunofluorescence assays can be used for the diagnosis of pouchitis.
Therapeutics of Pouchitis
Small Molecule Drug Therapy
Antibiotics (such as Metronidazole and Ciprofloxacin), steroids (Budesonide), and probiotics (De Simone formulation) can help reduce inflammation and symptoms in some cases of pouchitis.
Monoclonal Antibody Therapy
Drugs targeting tumor necrosis factor, such as infliximab, adalimumab, and ulinumab, have demonstrated efficacy in controlling inflammation and improving clinical outcomes in select individual populations.
Fecal microbiota transplantation (FMT) Therapy
The substantial evidence implicating dysbiosis in the pathogenesis of pouchitis, the restoration of a healthy gut microbiome through FMT holds promise in alleviating symptoms and individual outcomes.
Granulocyte and monocyte apheresis (GMA) Therapy
By modulating the immune response and inflammatory activity, GMA has shown efficacy in reducing systemic and local inflammation, leading to a decrease in intestinal mucosal inflammation in individuals.
Our Services
Our company has rich experience and professional research background, which can provide you with high-level research support, including the development of a platform for the diagnosis and therapeutic of rare diseases such as pouchitis and provide comprehensive support for your research work.
Platforms of Pouchitis Therapy Development
Animal Models of Pouchitis
The animal models can provide valuable insights into the underlying mechanisms of pouchitis. Our company can offer various animal models of pouchitis that have been created through gene modification or by inducing inflammation using chemical agents or drugs, to help you study the disease and potential therapeutic options.
| Chemical-induced Models | ||
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| Chemical agents such as dextran sulfate sodium (DSS) and trinitrobenzene sulfonic acid (TNBS) can cause acute colitis by damaging the colonic epithelium and disrupting the gut barrier. Subsequent IPAA surgery on these mice can induce pouchitis-like inflammation. | ||
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| Genetically Engineered Models | ||
| By using transgenic or gene editing techniques such as CRISPR/Cas9 to cause pouchitis-related gene mutations, researchers can induce inflammation in the gut, leading to pouchitis-like symptoms. | ||
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| Optional Species | Mice, Rats, Others | |
The models we offer can enable you to evaluate the pharmacokinetics analysis and drug safety evaluation before advancing to trials, and accelerating the development of new therapeutics for pouchitis. If you are interested in our services, please feel free to contact us for more details and quotation information of related services.
References
- LeBlanc, Jean-Frédéric, et al. "The Microbiome as a Therapy in Pouchitis and Ulcerative Colitis." Nutrients 13.6 (2021): 1780.
- Akiyama, Shintaro, et al. "Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and cc." Intestinal research 19.1 (2021): 1–11.
- Alphonsus, Lotus, et al. "Systematic review and meta-analysis of randomised controlled trials: Medical therapies for the treatment and prevention of pouchitis." Alimentary pharmacology & therapeutics 58.3 (2023): 268–282.
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.