Zusammenfassung
Zahlreiche Beobachtungen lassen einen Zusammenhang zwischen der Ätiopathogenese chronisch entzündlicher Darmerkrankungen und Störungen des Gerinnungssystems vermuten. In mehreren Publikationen wurde eine bei M. Crohn und Colitis ulcerosa nachweisbare Aktivierung des Gerinnungssystems beschrieben. Diese ist wahrscheinlich nicht nur Ursache einer erhöhten Inzidenz thrombembolischer Komplikationen, sondern möglicherweise auch ein wesentliches Element der pathophysiologischen Veränderungen an der Mikrovaskulatur der Darmwand. Allerdings ist bis dato noch unklar, ob die beobachteten Störungen des Gerinnungssystems eine (Teil-)Ursache oder lediglich die Folge des systemischen Entzündungsprozesses bei chronisch entzündlichen Darmerkrankungen sind. In jüngerer Vergangenheit wurde im Rahmen kleinerer unkontrollierter Studien wiederholt auf den Nutzen der Therapie mit Substanzen, die in das Gerinnungssystem eingreifen, hingewiesen. Aus diesen Untersuchungen wiederum lassen sich eine Reihe pathophysiologisch relevanter Beobachtungen ableiten.
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Literatur
Ahmed T, Abraham WM, D’Brot J (1992) Effects of inhaled heparin on immunologic and nonimmunologic bronchoconstrictor responses in sheep. Am Rev Respir Dis 145: 566–570
Bowler SD, Smith SM, Lavercombe PS (1993) Heparin inhibits the immediate response to antigen in the skin and lungs of allergic subjects. Am Rev Respir Dis 147: 160–163
Brazier F, Yzet T, Boruchowicz A, Colombel JF, Duchmann JC, Dupas JL (1996) Treatment of ulcerative colitis with heparin. Gastroenterology 110: A872
Bregenzer N, Caesar I, Andus T, Hamling J, Malchow H, Schreiber S, Schölmerich J (1999) Lack of clinical efficacy of additional factor XIII treatment in patients with steroid refractory colitis. The factor XIII study group. Z Gastroenterol 37: 999–1004
Chamouard P, Grunebaum L, Wiesel MJ, Sibilia J, Coumaros G, Wittersheim C, Baumann R, Cazenave JP (1998) Significance of diminished factor XIII in Crohn’s disease. Am J Gastroenterol 93: 610–614
Chang NS, Intrieri C, Mattison J, Armand G (1994) Synthetic polysulfated hyaluronic acid is a potent inhibitor for tumor necrosis factor production. J Leukoc Biol 55: 778–784
Collins CE, Rampton DS (1997) Review article: Platelets in inflammatory bowel disease - pathogenetic role and therapeutic implications. Aliment Pharmacol Ther 11: 237–247
Day R, Forbes A (1999) Heparin, cell adhesion and pathogenesis of inflammatory bowel disease. Lancet 354: 62–65
Day R, Daszak P, Talbot I, Forbes A (1999) Expression of syndecan-1 in inflammatory bowel disease and a possible mechanism of heparin therapy. Dig Dis Sci 44: 2508–2515
Dupas JL, Brazier F, Yzet T, Roussel B, Duchmann JC, Iglicki F (1996) Treatment of active Crohn’s disease with heparin. Gastroenterology 110: A900
Dwarakanath AD, Yu LG, Brookes C, Pryce D, Rhodes MJ (1995) Sticky neutrophils, pathergic arthritis, and response to heparin in pyoderma gangraenosum complicating ulcerative colitis. Gut 37: 585–588
Edwards R, Levine JB, Green R, Duffy M, Matthews E, Brande F, Rickles FR (1987) Activation of blood coagulation in Crohn’s disease: Increased plasma fibrinopeptide A levels and enhanced generation of monocyte tissue factor activity. Gastroenterology 92: 329–332
Evans RC, Rhodes JM (1995) Heparin, used i. v. and with sulphasalazine, appears to be effective in the treatment of refractory U.C., and warrants larger controlled trials. Gut 37 [Suppl 2]: A49
Folwaczny C, Fricke H, Endres S, Hartmann G, Jochum M, Loeschke K (1997) Antiinflammatory properties of unfractioned heparin in patients with highly active ulcerative colitis: A pilot study. Am J Gastroenterol 92: 911–912
Folwaczny C, Fricke H, Spannagl M, Loeschke K (1995) Heparin for therapy of ulcerative colitis: therapy of a concomitant phenomenon or indication of pathophysiology Z Gastroenterol 33: 723–724
Folwaczny C, Loeschke K, Schnettler D et al. (2000) Endothelial autoantibodies are a marker of disease susceptibility in inflammatory bowel disease but apparently not linked to persistent measles virus infection. Clin Immunol 95: 197–202
Folwaczny C, Noehl N, Endres SP, Heldwein W, Loeschke K, Fricke H (1997) Antinuclear auto-antibodies in patients with inflammatory bowel disease: High prevalence in first-degree relatives. Dig Dis Sci 42: 1593–1597
Folwaczny C, Spannagl M, Wiebecke B, Jochum M, Heldwein W, Loeschke K (1996) Heparin in the treatment of highly active inflammatory bowel disease ( IBD ). Gastroenterology 110: A908
Folwaczny C, Wiebecke B, Loeschke K (1999) Unfractioned heparin in the therapy of patients with highly active inflammatory bowel disease. Am J Gastroenterol 94: 1551–1555
Gaffney PR, Doyle CT, Gaffney A, Hogan J, Hayes DP, Annis P (1995) Paradoxical response to heparin in 10 patients with ulcerative colitis. Am J Gastroenterol 90: 220–223
Gaffney PR, Gaffney A (1996) Heparin therapy in refractory ulcerative colitis-an update. Gastroenterology 110: A913
Gaffney PR, O’Leary JI, Doyle CT (1991) Response to heparin in patients with ulcerative colitis. Lancet 337: 238–239
Gorrski A, Imiela J, Nosarzewski J (1993) Oral heparin in the treatment of rheumatoid arthritis. J Immunol 150:PA239
Helio T, Wartiovaara U, Halme L, Turunen UM, Mikkola H, Palotie A, Farkkila M, Kontula K (1999) Arg 506 Gln factor V mutation and Val 34 Leu Factor XIII polymorphism in finnish patients with inflammatory bowel disease. Scand J Gastroenterol 34: 170–174
Hudson M, Chitolie A, Hutton RA, Smith SH, Pounder RE, Wakefield AJ (1996) Thrombotic vascular risk factors in inflammatory bowel disease. Gut 38: 733–737
Hudson M, Hutton RA, Wakefield AJ, Sawyerr AM, Pounder RE (1992) Evidence for activation of coagulation in Crohn’s disease. Blood Coagul Fibrinolysis 3: 773–778
Hudson M, Wakefield AJ, Hutton RA, Sankey EA, Dhillon AP, More L, Sim R, Pounder RE (1993) Factor XHI a subunit and Crohn’s disease. Gut 34: 75–79
Iglicki F, Dupas JL (1996) Effect of heparin treatment on extraintestinal manifestations associated with inflammatory bowel disease. Gastroenterology 110: A872
Kaufman HJ, Taubin HL (1987) Non-steroidal anti-inflammatory drugs activate quiescent inflammatory bowel disease. Ann Intern Med 107: 513–516
Lam A, Borda IT, Inwood MJ, Thomson S (1975) Coagulation studies in ulcerative colitis and Crohn’s disease. Gastroenterology 68: 245–251
Langman MJS (1995) Can incoagulable blood protect against inflammatory bowel disease Gastroenterology 108: 1305–1307
Lantz M, Thysell H, Nilsson E, Olsson I (1991) On the binding of tumor necrosis factor ( TNF) to heparin and the release in vivo of the TNF-binding protein I by heparin. J Clin Invest 88: 2026–2031
Liebman HA, Kashani N, Sutherland D, McGehee W, Kam L (1998) The factor V Leiden mutation increases the risk of venous thrombosis in patients with inflammatory bowel disease. Gastroenteroloy 115: 830–834
Lorenz R, Born P, Olbert P, Classen M (1995) Factor XIII substitution in ulcerative colitis. Lancet 345: 449–450
Nelson RM, Cecconi O, Roberts WG, Aruffo A, Linhardt RJ, Bevilacqua MP (1993) Heparin oligosaccharides bind L- and P-selectin and inhibit acute inflammation. Blood 82: 3253–3258
Oshitani N, Kiano A, Hara J (1995) Deficiency of blood coagulation factor XIII in Crohn’s disease. Am J Gastroenterol 90: 1116–1118
Oshitani N, Nakamura S, Matsumoto T, Kobayashi K, Kitano A (1996) Treatment of Crohn’s disease fistulas with coagulation factor XIII. Lancet 347: 119–120
Sankey EA, Dhillon AP, Anthony A, Wakefield AJ, Sim R, More L, Hudson M, Sawyerr AM, Pounder RE (1993) Early mucosal changes in Crohn’s disease. Gut 34: 375–381
Seitz R, Leugner F, Katschinski M, Immel A, Kraus M, Egbring R, Goke B (1994) Ulcerative colitis and Crohn’s disease: Factor XIII, inflammation and haemostasis. Digestion 55: 361–367
Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Gonzalez D, Fontcuberta J (1995) Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease. Dig Dis Sci 40: 1183–1189
Spannagl M, Dick A, Folwaczny C, Loeschke K, Schramm W (1999) The factor V Leiden mutation in patients with inflammatory bowel disease. Gastroenterology 117: 280
Teixeira MM, Hellewell PG (1993) Suppression by intradermal administration of heparin of eosinophil accumulation but not oedema formation in inflammatory reactions in guinea-pig skin. Br J Pharmacol 110: 1496–1500
Thompson NP, Wakefield AJ, Pounder RE (1995) Inherited disorders of coagulation appear to protect against inflammatory bowel disease. Gastroenterology 108: 1011–1015
Torkvist L, Thorlacius H, Sjoquist U, Bohman L, Lapidus A, Flood L, Agren B, Raud J, Lofberg R (1999) Low molecular weight heparin as adjuvant therapy in active ulcerative colitis. Aliment Pharmacol Ther 13: 1323–1328
Van Bodegraaven AA, Tuynman HA, Schoorl M, Kruishoop AM, Bartels PCM (1995) Fibrinolytic split products, fibrinolysis, and factor XIII activity in inflammatory bowel disease. Scand J Gastroenterol 30: 580–585
Van Dullemen HM, Van Deventer SJ, Hommes DW, Bijl HA, Jansen J, Tytgat GN, Woody J (1995) Treatment of Crohn’s disease with anti-tumor necrosis factor chimeric monoclonal antibody (cA2). Gastroenterology 109: 129–135
Wakefield AJ, Ekbom A, Dhilllon AP, Pittilo MR, Pounder RE (1995) Crohn’s disease: Pathogenesis and persistent measles virus infection. Gastroenterology 108: 911–916
Wakefield AJ, Pittilo RM, Sim R (1993) Evidence of persistent measles virus infection in Crohn’s disease. J Med Virol 39: 345–353
Wakefield AJ, Sawyerr AM, Dhillon AP, Pittilo RM, Rowles PM, Lewis A A, Pounder RE (1989) Pathogenesis of Crohn’s disease: multifocal gastrointestinal infarction. Lancet 2: 1057–1062
Wakefield AJ, Sim R, Akbar ANand (1997) In situ immune responses in Crohn’s disease: a comparison with acute and persistent measles virus infection. J Med Virol 51: 90–100
White B, AngYS, Mahmud N, Keeling PWN, Smith OP (1999) Heparin and inflammatory bowel disease. Lancet 354: 1122–1123
Zahernakowa TV, Kashmenskaya NA, Maltseva IV (1984) Hemostasis and heparin therapy in non-specific ulcerative colitis. Soviet Med (Moskva): 110–113
Zavgorodniy LG, Mustyats AP (1982) The use of anticoagulants in combined therapy of nonspecific ulcerative colitis. Klin Med (Moskva) 60: 74–80
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Folwaczny, C. (2001). Gerinnungssystem und chronisch entzündliche Darmerkrankungen. In: Dignass, A., Stein, J. (eds) Chronisch entzündliche Darmerkrankungen. Gastroenterologie Update, vol 2000. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59556-1_11
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