Crohn´s disease

BACKGROUND: Genetic analyses have identified many variants associated with the risk of inflammatory bowel disease (IBD) development. Among these variants, the ones located within the NOD2 gene have the highest odds ratio of all IBD genetic risk variants. Also, patients with Crohn's disease (CD) have been shown to have an altered gut microbiome, which might be a reflection of inflammation itself or an effect of other parameters that contribute to the risk of the disease. Since NOD2 is an intracellular pattern recognition receptor that senses bacterial peptidoglycan in the cytosol and stimulates the host immune response (Al Nabhani et al...

BACKGROUND: Chronic inflammation is a key factor for the development of colorectal cancer (CRC) among patients with inflammatory bowel disease (IBD). Despite the increased use of biologic agents in patients with IBD, their impact on colorectal carcinogenesis remains unclear. With the use of a large database, we sought to describe the effect of biologics on CRC among patients with IBD. METHODS: We evaluated a multicenter database (Explorys) consisting of electronic medical records from several U...

Despite the development and introduction of new pharmaceutical approaches for Crohn's disease, the treatment of these patients still remains a major clinical challenge due to the heterogeneity in the course, degree of inflammation and localization. Over the last decade surgery was mainly reserved for the treatment of complications during the long course of Crohn's disease; however, due to new evidence-based knowledge, primary surgical resection in patients suffering from isolated Crohn's disease of the terminal ileum represents an equally effective alternative to medicinal antibody-based treatment...

INTRODUCTION: Endoscopy is an established diagnostic and therapeutic tool in paediatric gastroenterology and a save method with rare complications. PRESENTATION OF CASE: We present the case of an 11-year-old Caucasian boy with a long history of inflammatory bowel disease. Three years prior an ileostomy was created and is still in position. After diagnostic panendoscopy (colonoscopy, gastroscopy, endoscopy of small intestine via ileostomy) the patient showed progressive abdominal distension and pain...

Magnetic resonance (MR) enterography is now the preferred modality for evaluation of acute and chronic presentations of Crohn disease in pediatric patients. There has been increasing standardization in the performance and interpretation of these studies, given the growth in volume and impact on clinical management. This article will focus on technical considerations in the performance of MR enterography in children and adolescents, as well as "do not miss" findings on MR enterography that will impact clinical management and potential problems encountered with MR enterography that may limit its diagnostic utility in some patients...

BACKGROUND: Inflammatory bowel disease (IBD) is associated with an increased acute coronary syndrome (ACS) risk. Data are limited regarding the epidemiology and outcomes of ACS in patients with IBD. METHODS: A retrospective cohort analysis of patients with IBD admitted for ACS in the U.S. Healthcare Cost and Utilization Project National Inpatient Sample for 2005 to 2015 was conducted. We analyzed trends in IBD-ACS admissions and mortality, differences in risk profiles, management strategies, and in-hospital mortality between IBD-ACS and non-IBD ACS and between ulcerative colitis (UC) and Crohn disease (CD)...

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Current treatments for chronic immune-mediated diseases such as psoriasis, rheumatoid arthritis, or Crohn's disease commonly rely on cytokine neutralization using monoclonal antibodies; however, such approaches have drawbacks. Frequent repeated dosing can lead to the formation of anti-drug antibodies and patient compliance issues, and it is difficult to identify a single antibody that is broadly efficacious across diverse patient populations. As an alternative to monoclonal antibody therapy, anti-cytokine immunization is a potential means for long-term therapeutic control of chronic inflammatory diseases...

Background: In studies evaluating the microbiome, numerous factors can contribute to technical variability. These factors include DNA extraction methodology, sequencing protocols, and data analysis strategies. We sought to evaluate the impact these factors have on the results obtained when the sequence data are independently generated and analyzed by different laboratories. Methods: To evaluate the effect of technical variability, we used human intestinal biopsy samples resected from individuals diagnosed with an inflammatory bowel disease (IBD), including Crohn's disease ( n = 12) and ulcerative colitis ( n = 10), and those without IBD ( n = 10)...

Serotonin is a highly conserved and ubiquitous signaling molecule involved in a vast variety of biological processes. A majority of serotonin is produced in the gastrointestinal epithelium, where it is suggested to act as a prominent regulatory molecule in the inflammatory bowel diseases (IBDs) Crohn's disease (CD) and ulcerative colitis (UC). Extracellular and circulating serotonin levels are thought to be elevated during intestinal inflammation, but the underlying mechanisms have been poorly understood. The data on human material are limited, contradictory, and in need of further investigation and substantiating...

PURPOSE: To determine the utility of diffusion kurtosis imaging (DKI) for assessing bowel fibrosis and to establish a new magnetic resonance imaging (MRI)-based classification based on DKI and conventional MRI parameters for characterizing intestinal strictures in Crohn's disease (CD) using the histological evaluation of resected intestine samples as the reference standard. METHODS: Thirty-one patients with CD undergoing preoperative conventional MRI and diffusion-weighted imaging (DWI) (b values = 0-2000 s/mm2 ) were consecutively enrolled...

BACKGROUND: Therapeutic efficacy of biologics has remained at about 50% for 2 decades. In Crohn's disease (CD) patients, we examined the predictive value of an epithelial cell biomarker, ileal microvillar length (MVL), for clinical response to ustekinumab (UST) and vedolizumab (VDZ) and its relationship to another biomarker, intestinal epithelial cell (IEC) pyroptosis, with respect to response to VDZ. METHOD: Ileal biopsies from the UNITI-2 randomized controlled trial were analyzed for MVL as a predictor of clinical response to UST...

BACKGROUND: Recommendations for dietary fibre intake in patients with inflammatory bowel disease are highly variable. Despite the potential benefits of prebiotic fibres on the gut microbiome, many patients with inflammatory bowel disease follow a low fibre diet. The present study comprehensively evaluated intakes of total and prebiotic fibres in patients with inflammatory bowel disease, aiming to determine the adequacy of fibre intake and factors that may influence intake. METHODS: Outpatients with a formal diagnosis of inflammatory bowel disease were recruited to this multicentre cross-sectional study...

PURPOSE: The objectives of our study were to describe the ocular manifestations of Crohn's disease and to identify risk factors for ocular involvement. METHODS: We prospectively collected 71 cases of Crohn's disease. All patients underwent a complete ophthalmic examination. Two groups were identified according to the presence (group 1) or not (group 2) of ocular involvement related to Crohn's disease. Various parameters were compared between the 2 groups. RESULTS: The average age was 38±12 years...

OBJECTIVES: Current evidence on fecal microbiota transplantation for inflammatory bowel disease is inconclusive. We conducted a systematic review to gather evidence on the efficacy and safety of fecal microbiota transplantation for inflammatory bowel disease. METHODS: Systematic searches were conducted in PubMed, Scopus, and Web of Science. Clinical remission was considered as the primary endpoint. Pairwise meta-analyses were performed for the randomized controlled studies (Mantel Haenszel, random effects model)...

A possible classical complication of Crohn's disease is the formation of a stenosis, which can occur throughout the course of the disease and can present differently depending on the narrowing of the lumen. This article reports the case of a 39-year-old male patient with a stenosing terminal ileitis, which was ultimately only manifested after obstruction by a foreign body.

BACKGROUND: The neutrophil fecal biomarkers, calprotectin (FCP) and lactoferrin (LCT), and peripheral blood neutrophil CD64 surface receptor (nCD64) are biomarkers for mucosal inflammation in inflammatory bowel disease (IBD). Although FCP has been evaluated as a biomarker for mucosal healing, cut points for LCT and nCD64 are less known. We aimed to identify the cut points for LCT and nCD64 that were associated with FCP remission, with a secondary aim to evaluate the relationship between biochemical outcomes and infliximab (IFX) trough concentrations...

Filgotinibis aselective Janus kinase 1 inhibitor drug which is currently under investigation for the treatment of rheumatoid arthritis and Crohn s disease. The aim of the present study was to develop an accurate, simple and sensitive LC-MS/MS method for the determination of filgotinib (FLG) in human liver microsomes (HLMs) and its application to a metabolic stability study. Chromatographic separation was carried on using of a reversed phase C18 column. The mobile phase was mixture of acetonitrile and ammonium formate (10 mM, pH 3...

INTRODUCTION: Diffusion-weighted magnetic resonance imaging (DWI- MRI) has the potential for identifying inflamed bowel segments for patients with Crohn's disease (CD). OBJECTIVES: We aimed to determine diffusion-weighted imaging (DWI) value to predict active CD and compare apparent diffusion coefficients (ADC) with endoscopic and conventional magnetic resonance imaging (MRI) CD activity indices. PATIENTS AND METHODS: Overall, 229 patients with suspected and diagnosed CD prospectively underwent magnetic resonance enterocolonography (MR-EC) with DWI sequence and ileocolonoscopy...

OBJECTIVES: There is need for biomarkers as predictors of outcome to medical treatment in Crohn's disease. The purpose of this study was to evaluate the predictive performance of fecal calprotectin for short- and long-term clinical and endoscopic outcomes. METHODS: This post-hoc analysis of the UNITI/IM-UNITI studies (NCT01369329, NCT01369342, and NCT01369355; YODA #2019-4026) included 677 patients to evaluate the relationship of week 6 calprotectin cut-offs and changes from baseline assessments in calprotectin for prediction of outcomes at weeks 8, 32, and 52 using receiver operating characteristic curves with comparisons of areas under the curve (AUC)...