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Neurological Complications of Anti-TNF Treatments and Other Neurological Aspects of Inflammatory Bowel Disease

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Abstract

Inflammatory bowel diseases (IBD) result from dysregulated immune responses in the bowel. They are characterised by pathology mediated by immune cells with upregulated inflammatory profile. These disorders of immune regulation often coexist with other inflammatory conditions with altered immunoregulatory activities, including multiple sclerosis, rheumatoid arthritis, psoriasis, etc. Treatments targeting the pro-inflammatory cytokine, tumour necrosis factor alpha (TNFα), such as antibodies or soluble receptors, have revolutionised the management of IBD. However, paradoxically, such treatments have been associated with a risk of developing demyelinating disease, often typical multiple sclerosis. This chapter reviews the literature on the known prevalence and risk of demyelination in patients with IBD receiving TNF inhibitors, discusses potential mechanisms and also addresses the immunopathogenic, environmental and genetic commonalities of IBD and central nervous system demyelinating disease.

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Authors and Affiliations

  1. Department of Clinical Neurology, Leicester General Hospital, Leicester, UK

    Su-Yin Lim MBBS, MRCP, MD

  2. Department of Clinical Neuroscience, University of Nottingham, University Hospital, Queen’s Medical Centre, Nottingham, UK

    Cris S. Constantinescu MD, PhD

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  1. Su-Yin Lim MBBS, MRCP, MD
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  2. Cris S. Constantinescu MD, PhD
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Correspondence to Cris S. Constantinescu MD, PhD .

Editor information

Editors and Affiliations

  1. Neurology, C Floor South Block, University of Nottingham, Nottingham, United Kingdom

    Cris Constantinescu

  2. Atlantic Digestive Health Institute, Morristown Medical Center, Columbus, Ohio, USA

    Razvan Arsenescu

  3. Armedica LLC, Columbus, Ohio, USA

    Violeta Arsenescu

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Lim, SY., Constantinescu, C.S. (2016). Neurological Complications of Anti-TNF Treatments and Other Neurological Aspects of Inflammatory Bowel Disease. In: Constantinescu, C., Arsenescu, R., Arsenescu, V. (eds) Neuro-Immuno-Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-28609-9_12

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