Helminthes Use In Treatment Of Autoimmune Disease

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Helminthes Use In Treatment Of Autoimmune Disease

  1. 1. ‫استعمال الديدان في عالج أمراض المناعة الذاتية‬Designed by:Ahmed Kamal Abdel Aziz Faculty Of Pharmacy Helwan UniversityDepartment Of Microbiology And Immunology
  2. 2. Content: What is the Autoimmunity? What is the Helminthes therapy ? Helminthes characteristics required for use in therapy. Side Effects of Helminthes therapy. Cohns disease.
  3. 3. What is the Autoimmunity? Autoimmunity: is a disease in which the immune system mistakenly recognizes self tissues as foreign, and attacks them.By Nessma Mohamed
  4. 4. Autoimmune disease, where ? north america europe asia pacific row 8% 20% 42% 30%
  5. 5. TOLERANCE TOLERANCE CLASSIFIED TO:1-TOLERANCE TO SELF ANTIGENS : AS AUTOIMMUNE DISEASE2-TOLERANCE TO NON- SELF ANTIGENS
  6. 6. GENERAL CLASSIFICATION an organ-specific category a non-organ-specific category
  7. 7. What is the Helminthes therapy ? By Marwa Said
  8. 8. What is the Helminthes therapy ?There are currently two closely related treatments available, either 1)inoculation with Necator americanus, commonly known as Hookworms, 2)trichuris Suis Ova, commonly known as Pig Whipworm Egg.
  9. 9. tableMechanism of action
  10. 10. Do All Helminthes Can Be Used ??????
  11. 11. Helminth characteristics requiredfor use in therapy should not have the potential to cause disease in man at therapeutic doses should not be a potential vector for other parasites, viruses, or bacteria should not be easily transmissible from the host to other people should be compatible with a patients existing medication should have a significant period of residence in the host must be easily eradicated from the host, if required
  12. 12. Side Effect: a rash at the inoculation site, nausea, diarrhea, gas, bloating, cramping, epigastric pain and episodes of fatigue. In extreme cases, the diarrhea can be debilitatingand the epigastric pain intense, causing termination of therapy.
  13. 13. Crohns disease Burrill B. CrohnBy Ahmed Kamal
  14. 14. content What Is Crohns Disease? What Are The Symptoms Of Crohn’s Disease ? What Causes Crohn’s Disease ? How Is Crohn‘s Disease Diagnosed? Can This Condition Be Prevented? Treatment (Drugs). Surgical Therapy. Helminthes Therapy . Videos (interview with patients experiment the helminthes therapy)
  15. 15. What is Crohns Disease? Crohns disease: is a form of inflammatory bowel disease that begins with localized inflammatory collections and aphthous ulcers in the bowel mucosa progressing to inflammation through the bowel wall. Where ? It tends to be localized in the terminal part ofthe ileum and right colon.Crohns also has the tendency to be fistulizing(the formation of tracts, called fistules). Anatomic distribution of Crohn’s disease
  16. 16.  Inflammatory bowel disease (IBD) encompasses two idiopathic, chronic, inflammatory diseases:Crohn’s disease.Ulcerative colitis. Inflammatory bowel disease subsets.
  17. 17. Anatomic distribution of Crohn’sdisease and ulcerative colitis.
  18. 18. Comparison of the appearance of normal, Crohn’s, and ulcerative colitis mucosa;gross (top); histological (center); endoscopic (bottom).
  19. 19. Geographic distribution of Crohn’sdisease.
  20. 20. Incidence of Crohn Disease at SpecificLocales Over Time
  21. 21. Types of Crohn’s disease:A, stenosing;B, inflammatory;C, fistulizing;D, radiographic image of fistula.
  22. 22. What are the symptoms of Crohn’s disease ?predominant symptoms:Diarrhea,cramping abdominal pain,weight loss .These complaints may be vague forthe first few months or years..Other symptoms associated with Crohns:fever,anorexia,abdominal tenderness. Extraintestinal manifestations of Crohn’s disease
  23. 23. What causes Crohn’s disease ?
  24. 24. Genetic Factors Familial empiric risk of inflammatory bowel disease
  25. 25. Immune System Protective and hostile factors in Crohn’s disease; A, protective factors emphasized; B, hostile factors emphasized.
  26. 26. How is Crohn’s disease diagnosed?
  27. 27. How is Crohn’s disease diagnosed? Barium contrast x-rays and CT scans (computerized tomography) are the least invasive methods and are usually performed first. Flexible sigmoidoscopy and colonoscopy with biopsiesdemonstrate focal inflammation and sometimes granulomas even when there are no gross findings. Radiographic Diagnosis
  28. 28. Endoscopic DiagnosisPatient positioning for sigmoidoscopy andcolonoscopy A, Sigmoidoscope position in the colon; B, tip of sigmoidoscope; C, endoscopic image.
  29. 29. Colonoscopy A, Position of the colonoscope in the colon; B, endoscopic view; Biopsy of colonic mucosa. C, colonoscope tip
  30. 30. Can this condition be prevented?  Because heredity plays and important role in this disease, barring the advent of genetic engineering, prevention is not an option. But,Early detection with flexible sigmoidoscopyand colonoscopy, however, is a viable option infamilies who are genetically predisposed.
  31. 31. By Ahmed Fathi
  32. 32. Medical Therapy Anti-Inflammatory Drugs. Antibiotics. Steroid Drugs. Immunomodulator Drugs. Biologic Therapies . Surgical Therapy. Helminthes therapy . Therapeutic Pyramid.
  33. 33. Treatment (cont.) Anti-Inflammatory DrugsAminosalicylates Sulfasalazine and 5-ASA preparations inhibit the function of lymphocytes, monocytes, and plasma cell production of immunoglobulins Sites of 5-aminosalicylic acid (5-ASA) activity
  34. 34. Treatment (cont.)Antibiotics Ciprofloxacin has been used in combination with metronidazole for ileal and perianal disease. Ciprofloxacin
  35. 35. Treatment (cont.) Steroid DrugsAdrenocorticosteroids (e.g., prednisone 40–60 mg/d),in combination with other anti-inflammatorydrugs (e.g., sulfasalazine or mesalamine),Patients with predominantly ileal involvementare the most responsive Sites of steroid activity.
  36. 36. Immunomodulator Drugs Glucocorticoids, Azathioprine, Infliximab, Cyclosporine, Methotrexate.
  37. 37. Immunomodulator Drugs (cont.) Immunomodulator therapy (azathioprine and 6-mercaptopurine [6-MP]) Two or three months of therapy are usually needed before results are seen. azathioprine Recommended dosage adjustment for 6-MP and azathioprine according to TPMT-metabolising type (Krynetsky & Evans, Pharmacology 61:136, 2000; Brockmöller et al, Eur J Clin Pharacol 64:133, 2008).
  38. 38. Immunomodulator Drugs (cont.) potent T cell inhibitor, cyclosporine, has demonstrated rapid onset of action.
  39. 39. Immunomodulator Drugs (cont.) Methotrexate(IM), is effective for 9–12 months
  40. 40. Surgical therapyBy Ahmed Kamal
  41. 41. Surgical therapy A, Resection of the cecum and ileum; B, with ileocolonic anastomosis.
  42. 42. Abscesses and Fistulae A, Resection of the cecum and ileum; B, ileorectal anastomosis.
  43. 43. Obstruction A, Ileal obstruction; B, repaired with ileocolonic anastomosis.
  44. 44. Colectomy Proctocolectomy and Brooke ileostomy.
  45. 45. In cases of Crohn’s colitis with rectal sparing, colectomywith ileorectal anastomosis is the procedure of choice A,B, Ileal obstruction; C-E, stricturoplasty
  46. 46. Helminthes therapy Necator Americanus, Commonly Known As Hookworms, Trichuris Suis Ova, Commonly Known As Pig Whipworm Egg.
  47. 47. Hook-worm
  48. 48. Time to Improvement for,Trichuris Suis -ResponsivePatients With Ulcerative Colitis asMeasured by the Simple ClinicalColitis Activity Index (SCCAI)
  49. 49. Pooled Response Rates for Patients WithUlcerative Colitis Treated With,Placebo or Trichuris Suis .
  50. 50. Teamwork Ahmed Kamal Abdel Aziz Ahmed Fathi Abdel Samia Marwa Said Nessma Mohamed

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