![]() Control samples were attained from patients who underwent such an examination but in whom all clinical investigations subsequently turned out to be normal, e.g., a diagnosis of irritable bowel syndrome was reached [īlood was drawn from TNF inhibitor–experienced patients with UC and diluted 1:1 with phosphate-buffered saline (PBS), following isolation of peripheral blood mononuclear cells (PBMCs) by Ficoll-Paque density gradient centrifugation (GE Healthcare, Uppsala, Sweden). Colonic biopsies for COX-2 immunohistochemistry (IHC) were collected from routine colonoscopies of patients with UC, including Rs (n = 10) and PNRs (n = 10), and healthy control subjects (n = 10). Blood samples were obtained from patients with UC, including Rs (n = 10) and PNRs (n = 10), and healthy control subjects (n = 6). When blood samples were obtained, the Rs were placed on maintenance TNF inhibitor therapy while PNRs received second-line therapy ( Supplemental Table S1), and the median clinical Mayo score in both Rs and PNRs was 0 ( Supplemental Table S1). Except two PNRs who underwent colectomy, all the PNRs were switched out of therapeutic class to e.g., the anti-integrin, vedolizumab, combined with other treatments (e.g., thiopurines like azathioprine, glucocorticoids, and 5-aminosalicylic acid at week 14). In turn, a PNR was defined as a patient without clinically relevant improvement in Mayo score (i.e., a decline in score from baseline of <3 despite induction therapy with a TNF inhibitor). The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology. ![]()
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