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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. 1 Gastroenterology Service, ASL BAT, Andria, BT, Italy
  2. 2Section of Gastroenterology, Department of Medical Sciences and Organ Transplantation, University of Bari, Bari, Italy
  3. 3 Division of Surgery, “Paolo Colombo” Hospital, ASL Roma H, Velletri (Roma), Italy
  4. 4 Division of Pathology, Lorenzo Bonomo Hospital, ASL BAT, Andria, BT, Italy
  5. 5 Division 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}

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Two recent papers by Leal et al 1 and by Yarur et al 2 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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  • Contributors Substantial contributions to the conception or design of the work: acquisition, analysis and interpretation of data: AT, MPr, MPi, FG, CDI, DP, EI; drafting the work or revising it critically for important intellectual content: AT, MPi, EI; final approval of the version published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: AT, MPr, MPi, FG, CDI, DP, EI.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.