Considering these two different pathogenetical ways is adalimumab just as suitable in UC as in CD? Aim: assessment of intracellular changes of colonic mucosa in UC, before and after adalimumab treatment; Methods: Eight patients (21–62 years, 7 women) with moderate/severe UC (Disease Activity Index-UCDAI > 6, Endoscopic

Index-EI > 4) were included. All patients received adalimumab (Humira) subcutaneous: 160 mg at week 0, 80 mg at week 2 and afterwards 40 mg at a 2 week interval. Colonoscopy was performed before and 6 months after the initial administration of adalimumab. Biopsies obtained during colonoscopy were processed specifically, stained with uranyl acetate and check details lead citrate and examined with a JEM-1010 transmission electron microscope. Results: Before treatment we noticed severe alterations of the epithelium- depletion of microvilli, shattering of epithelial junctions, cytoplasmic vacuolization,

dilatation of the endoplasmic reticulum, pycnotic nuclei, destruction of mitochondria and Golgi complexes which conducted to drastic reduction of cell metabolism. Rarefaction of the goblet cells, together with abnormal mucus formation and secretion was observed. The corresponding chorion showed degeneration of collagen fibres and smooth muscle cells, obstructed capillaries, neutrophilic and mononuclear infiltration. After adalimumab therapy, we noticed improvement in morphology www.selleckchem.com/products/fg-4592.html and function of epithelial organelles, rich Tyrosine-protein kinase BLK mucus secretion and recovery of the chorionic components. The clinical response observed in all our patients was supported by a descent in UCDAI. Endoscopic severity diminished as well- with 7 out of 8 cases entering remission (EI≤4). Conclusion: At the end of treatment the ultrastructural assessment clearly showed signs of epithelial barrier recovery -one of the goals of UC treatment. These features may contribute to a better understanding of UC pathogenicity and mechanism of action of the anti-TNF-alpha therapies. Key Word(s): 1. ulcerative colitis; 2. adalimumab; 3. ultrastructure;

Presenting Author: CONG LIANG Additional Authors: LIN ZHOU, JIE LIANG, YONGZHAN NIE, KAICHUN WU, DAIMING FAN Corresponding Author: KAICHUN WU Affiliations: Xijing Hospital of Digestive Disease; Xijing Hospital of Digestive Disease Objective: Infliximab has been an important agent for inflammatory bowel disease (IBD) in the past decade. 40–50% of the patients lose response initially or after a period of time, which critically restricts the efficacy. Quite a few studies suggest loss of response may be contributed by the formation of antibodies-to-infliximab (ATIs). However, the relationship between ATIs and clinical response to Infliximab remains controversial. Thus, the aim of this study was to identify whether ATIs could be a predictor of loss of response to infliximab. Methods: We searched PubMed, EMBASE and the Cochrane Library for controlled trials to April 2013.