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Persistence of endoscopic rectal inflammation in UC treated with infliximab is not linked to ineffective TNFα downregulation
  1. Antonio Tursi1,
  2. Mariabeatrice Principi2,
  3. Marcello Picchio3,
  4. Floriana Giorgio2,
  5. Cosimo Damiano Inchingolo4,
  6. Domenico Piscitelli5,
  7. Enzo Ierardi2
  1. 1Gastroenterology Service, ASL BAT, Andria, BT, Italy
  2. 2Section of Gastroenterology, Department of Medical Sciences and Organ Transplantation, University of Bari, Bari, Italy
  3. 3Division of Surgery, “Paolo Colombo” Hospital, ASL Roma H, Velletri (Roma), Italy
  4. 4Division of Pathology, Lorenzo Bonomo Hospital, ASL BAT, Andria, BT, Italy
  5. 5Division of Pathology, University of Bari, Bari, Italy
  1. Correspondence to Dr Antonio Tursi, Gastroenterology Service, ASL BAT, Via Torino, 49, Andria, BT 76123, Italy; antotursi{at}tiscali.it

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Two recent papers by Leal et al1 and by Yarur et al2 focalised their attention on the mechanisms of Tumour Necrosis Factor α (TNF) inhibition by anti-TNFα in patients suffering from IBDs. In particular, Yarur et al found that the ration anti-TNF/TNF in tissue was highest in uninflamed areas and lowest in severely inflamed areas, and claimed that TNFα overexpression in local tissue inflammation characterised serves as a sink for anti-TNF.1 Moreover, Leal et al found that anti-TNFα therapy significantly downregulates a subset of inflammatory genes even in patients who fail to achieve endoscopic remission, suggesting that these genes may not be dominant in driving inflammation in non-responders.2

We reported herein our experience in assessing TNFα mucosal expression and mucosal healing (MH) in UC under treatment with infliximab (IFX). We revised the MH and TNFα expression before and after IFX treatment in …

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