Inflammatory Bowel Diseases最新文献

{"title":"Endoscopic Recurrence in Crohn's Disease Patients With Long-Term Ileostomy.","authors":"Lotte Oldenburg, Brecht Hens, Maxime Hollenberg, Geert D'Haens","doi":"10.1093/ibd/izaf153","DOIUrl":"https://doi.org/10.1093/ibd/izaf153","url":null,"abstract":"<p><strong>Background: </strong>A small but significant proportion of patients with Crohn's disease (CD) will ultimately require a permanent ileostomy. So far, research has focused primarily on clinical and surgical recurrence rates in the ileum, leaving endoscopic recurrence largely unexplored. The aim of this study was to explore the endoscopic ileal recurrence rate in patients with a long-term ileostomy and to identify potential risk factors.</p><p><strong>Methods: </strong>We performed a retrospective study of adult CD patients with a long-term ileostomy (≥12 months) at a tertiary referral center.</p><p><strong>Results: </strong>Through an electronic health record database search, we were able to identify 150 patients. One hundred sixteen patients (77.3%) underwent at least one endoscopic examination of the ileum. Ileal recurrence was detected in 46/116 (39.7%). The 1, 3, and 5-year endoscopic recurrence rates were 11.2%, 27.3%, and 33.0%, respectively. Patients with earlier ileal involvement (hazard ratio [HR] 1.99, 95% confidence interval [CI] 1.09-3.62; P = .02) or previous biological therapy (HR 2.48, 95% CI 1.25-4.89; P = .01) were at higher risk. Fecal calprotectin in ileostomy effluent accurately predicted endoscopic inflammation at a cutoff of 170 mcg/g (sensitivity 77.8%, specificity 94.7%, accuracy 89.9%).</p><p><strong>Conclusions: </strong>In this retrospective study, 77.3% of ileostomy patients underwent endoscopic assessment during follow-up. Ileal recurrence was detected in 39.7% of patients who underwent endoscopic evaluation. Patients with ileal involvement or preoperative exposure to biologics had the highest risk of recurrence. These patients might benefit from endoscopic monitoring. Fecal calprotectin is a reliable noninvasive marker for detecting ileal inflammation.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Inflammatory Bowel Disease and Eosinophilic Esophagitis: True Link or Surveillance Artifact?","authors":"Cong Dai, Yu-Hong Huang","doi":"10.1093/ibd/izaf151","DOIUrl":"https://doi.org/10.1093/ibd/izaf151","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Safety of Small Bowel Capsule Endoscopy in Very Early-Onset Inflammatory Bowel Disease: A Multi-Institutional Study.","authors":"Shin-Ichiro Hagiwara, Hirotaka Shimizu, Ryusuke Nambu, Keisuke Jimbo, Emiri Kaji, Takuya Nishizawa, Fumihiko Kakuta, Itaru Iwama, Takashi Ishige, Takahiro Kudo, Katsuhiro Arai","doi":"10.1093/ibd/izaf144","DOIUrl":"https://doi.org/10.1093/ibd/izaf144","url":null,"abstract":"<p><strong>Background: </strong>Small bowel capsule endoscopy is a valuable modality for evaluating small intestinal lesions in children with inflammatory bowel disease. However, its application for very early-onset inflammatory bowel disease remains insufficiently documented. This study investigated the feasibility and safety of small bowel capsule endoscopy for very early-onset inflammatory bowel disease.</p><p><strong>Methods: </strong>A cohort of patients with very early-onset inflammatory bowel disease who underwent small bowel capsule endoscopy at under 6 years of age between January 2013 and December 2022 at 7 Japanese pediatric centers was included. Their medical records were retrospectively reviewed for actual procedures, safety, and test results.</p><p><strong>Results: </strong>Eighty-two patients (21 with ulcerative colitis, 25 with Crohn's, 31 with inflammatory bowel disease-unclassified, 4 with monogenic inflammatory bowel disease, and 1 with intestinal Behçet's disease) were enrolled, and 104 small bowel capsule endoscopies (median age, 3.8 years; median body weight, 13.0 kg) were analyzed. All capsules were deployed endoscopically, mostly using delivery devices (95%). Gastrointestinal patency was assessed in 95% of procedures, most commonly using patency capsules (70%). Abnormal small bowel findings were observed in 42% of patients, with aphthae being the most common (34%), followed by ulcers (18%). No serious complications, including small intestinal retention and perforation, were reported.</p><p><strong>Conclusions: </strong>Small bowel capsule endoscopy for very early-onset inflammatory bowel disease is feasible with diagnostic utility, and it can be performed safely with appropriate evaluation using patency capsules.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally Informed Digital Behavioral Intervention Development for Inflammatory Bowel Disease: A Qualitative Study.","authors":"Ruby Greywoode, Alicia Philippou, Thomas Ullman, Laurie Keefer","doi":"10.1093/ibd/izaf145","DOIUrl":"https://doi.org/10.1093/ibd/izaf145","url":null,"abstract":"<p><strong>Background: </strong>Recognition of the bidirectional effects between psychological distress (ie, anxiety, depression, perceived stress) and inflammatory bowel disease (IBD) activity has led to efforts to integrate behavioral medicine in the management of IBD. As part of a broader project focused on testing the feasibility and acceptability of digital mind-body interventions among a greater diversity of people with IBD, we collected qualitative data on the lived experience of patients from Black and/or Hispanic backgrounds in an outpatient gastroenterology setting. We aimed to understand how racial and ethnic background influences patients' illness perceptions and receptivity to a digital mind-body intervention for psychological distress in IBD.</p><p><strong>Methods: </strong>Data were collected (2022-2023) via semi-structured interviews among IBD patients (n = 25) attending an outpatient gastroenterology practice. All data collection occurred virtually and was audio recorded. Transcripts were thematically analyzed and coded via NVivo software.</p><p><strong>Results: </strong>We identified 3 core themes regarding the influence of racial and ethnic background on IBD experience with relevance to intervention design and content: broad impact of racial and cultural identity on IBD; resonance of gut-brain interaction with personal experience notwithstanding barriers to mental healthcare; and acceptance of digital technology in everyday life and health. For most, digital technology was part of their everyday life, and a digitally delivered self-management resource would be welcome.</p><p><strong>Conclusions: </strong>Racial and ethnic background influences IBD patients' illness perception, coping, and desires for support. Findings can directly inform the design and content of digital behavioral interventions in IBD towards increased applicability and equitable engagement.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"The Association of Inflammatory Bowel Disease and Eosinophilic Esophagitis: True Link or Surveillance Artifact?","authors":"Russell Yanofsky, Parul Tandon","doi":"10.1093/ibd/izaf149","DOIUrl":"10.1093/ibd/izaf149","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Improving Brain-Gut Studies in Crohn's Disease: Methodological Considerations\".","authors":"Anne Kerstin Thomann, Robert Christian Wolf","doi":"10.1093/ibd/izaf051","DOIUrl":"10.1093/ibd/izaf051","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2049-2050"},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Anti-Tumor Necrosis Factor Levels During Maintenance Phase Are Associated With Treatment Failure in Children With Crohn's Disease.","authors":"Jonathan Moses, Jeremy Adler, Shehzad A Saeed, Ann M Firestine, Joseph A Galanko, Rana F Ammoury, Dorsey M Bass, Julie A Bass, Monique Bastidas, Keith J Benkov, Athos Bousvaros, José M Cabrera, Kelly Y Chun, Jill M Dorsey, Dawn R Ebach, Ajay S Gulati, Hans H Herfarth, Anastasia Ivanova, Traci W Jester, Jess L Kaplan, Mark E Kusek, Ian H Leibowitz, Tiffany M Linville, Peter A Margolis, Phillip Minar, Zarela Molle-Rios, Barbara Joanna Niklinska-Schirtz, Kelly K Olano, Lourdes Osaba, Pablo J Palomo, Dinesh S Pashankar, Lisa Pitch, Charles M Samson, Kelly C Sandberg, Steven J Steiner, Jennifer A Strople, Jillian S Sullivan, Jeanne Tung, Prateek Wali, David A Wohl, Mike Zikry, Brendan M Boyle, Michael D Kappelman","doi":"10.1093/ibd/izae239","DOIUrl":"10.1093/ibd/izae239","url":null,"abstract":"<p><strong>Background: </strong>Higher drug levels and combination therapy with low-dose oral methotrexate (LD-MTX) may reduce anti-tumor necrosis factor (TNF) treatment failure in pediatric Crohn's disease. We sought to (1) evaluate whether combination therapy with LD-MTX was associated with higher anti-TNF levels, (2) evaluate associations between anti-TNF levels and subsequent treatment failure, and (3) explore the effect of combination therapy on maintenance of remission among patients with therapeutic drug levels (>5 µg/mL for infliximab and >7.5 µg/mL for adalimumab).</p><p><strong>Methods: </strong>We conducted a post hoc analysis of the COMBINE trial, which compared anti-TNF monotherapy to combination therapy with LD-MTX. We included participants who entered maintenance therapy and provided a serum sample approximately 4 months from randomization.</p><p><strong>Results: </strong>Among 112 infliximab and 41 adalimumab initiators, median drug levels were similar between combination therapy and monotherapy (infliximab: 8.8 vs 7.5 μg/mL [P = .49]; adalimumab: 11.1 vs 10.5 μg/mL [P = .11]). Median drug levels were lower in patients experiencing treatment failure (infliximab: 4.2 vs 9.6 μg/mL [P < .01]; adalimumab: 9.1 vs 12.3 μg/mL [P < .01]). Among patients treated with infliximab with therapeutic drug levels, we observed no difference in treatment failure between participants assigned monotherapy or combination therapy. Among patients treated with adalimumab, a trend towards reduced treatment failure in the combination therapy arm was not statistically significant (P = .14).</p><p><strong>Conclusions: </strong>LD-MTX combination was not associated with higher drug levels, but higher drug levels were associated with reduced risk of treatment failure. Among patients with therapeutic drug levels, we observed no benefit of LD-MTX for patients treated with infliximab. A nonsignificant trend towards reduced treatment failure with the addition of LD-MTX patients treated with adalimumab warrants further investigation.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1841-1850"},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Biologic Therapy After Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis.","authors":"Maya Fischman, Lihi Godny, Adi Friedenberg, Revital Barkan, Ian White, Nir Wasserberg, Keren Rabinowitz, Irit Avni-Biron, Hagar Banai, Yifat Snir, Yelena Broitman, Henit Yanai, Iris Dotan, Jacob E Ollech","doi":"10.1093/ibd/izae272","DOIUrl":"10.1093/ibd/izae272","url":null,"abstract":"<p><strong>Background: </strong>Patients with ulcerative colitis (UC) undergoing proctocolectomy and ileal pouch-anal anastomosis (IPAA) may eventually require biologic therapy. Factors associated with biologic therapy after IPAA have not been previously studied.</p><p><strong>Methods: </strong>All patients with UC after total proctocolectomy and IPAA who were followed at Rabin Medical Center comprehensive pouch clinic and who consented to prospective observational follow-up were included. The primary outcome was the initiation of biologic therapy after IPAA. Cox proportional hazard models were used to evaluate potential associations.</p><p><strong>Results: </strong>Out of 400 patients receiving their care at the pouch clinic, 148 patients consented to prospective observational follow-up and constituted the study cohort. The median age at diagnosis was 21 years and the age at IPAA was 30 years. Median time-to-biologic therapy initiation post-IPAA was 9.2 years, with 34 patients (23%) initiating biologic therapy: Associated factors for initiating biologic therapy post-IPAA were preoperative treatment with biologic therapy and immunomodulatory therapy (hazard ratio [HR] 6.1 and 3.6, respectively, P < .001); Arab descent (HR 5.3, P < .001); heterozygosity of NOD2 variant rs2066845 (HR 5.1, P = .03); past smoking status (HR 2.3, P = .03); 3-stage IPAA (HR 2.3, P = .02); immediate postoperative complications (HR 2.1, P = .033); and pediatric-onset UC (HR 2.1, P = .03). None of the patients undergoing IPAA due to dysplasia (n = 27) required biologic therapy.</p><p><strong>Conclusions: </strong>Several demographic, disease-related, surgery-related, and genetic factors associated with post-IPAA biologic therapy were identified. Physicians treating patients with UC undergoing colectomy should incorporate these factors into their decision-making process. These patients may benefit from closer postoperative follow-up, and earlier initiation of biologic therapy should be considered.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1934-1942"},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Course and Prognostic Factors in Pediatric Ulcerative Proctitis: A Multicenter Cohort Study.","authors":"Ayako Miyazawa, Ryusuke Nambu, Hirotaka Shimizu, Takahiro Kudo, Takuya Nishizawa, Hideki Kumagai, Shin-Ichiro Hagiwara, Emiri Kaji, Tatsuki Mizuochi, Shingo Kurasawa, Fumihiko Kakuta, Takashi Ishige, Toshiaki Shimizu, Itaru Iwama, Katsuhiro Arai","doi":"10.1093/ibd/izae266","DOIUrl":"10.1093/ibd/izae266","url":null,"abstract":"<p><strong>Background: </strong>Although ulcerative proctitis (UP) in children is considered relatively mild, some patients have proximal disease extension and require immunosuppressive treatment. We investigated clinical characteristics and course of refractory UP in a multicenter pediatric cohort.</p><p><strong>Methods: </strong>Analyzing data obtained between 2013 and 2022 at 10 institutions specializing in pediatric inflammatory bowel disease, we elucidated natural history and factors predicting a need for immunosuppressive UP treatment. We compared patients given immunosuppressants and/or biologic agents (immunosuppressive treatment group) with those given 5-aminosalicylic acid (5-ASA) alone (5-ASA group).</p><p><strong>Results: </strong>Fifty-five patients were followed for 3.5 years. The median Pediatric Ulcerative Colitis Activity Index at diagnosis was 20. The commonest treatment, 5-ASA suppository monotherapy in 40% of patients, showed the worst compliance. Clinical remission was achieved at least once in 95% of all patients. Disease extension beyond the splenic flexure occurred in 51%. Immunosuppressive treatment was given to 37%; biologic agents were used for 18%. Rates of endoscopically demonstrated inflammation, including Ra/Rs at diagnosis and extension beyond the left-sided colon, were higher in the immunosuppressive treatment group (70% vs 38%, P < 0.05; 95% vs 27%, P < 0.0001). The log-rank test and multivariate Cox proportional hazards regression showed that time to first clinical remission exceeding 3 months predicted the need for biologics.</p><p><strong>Conclusion: </strong>The typical initial treatment of pediatric UP was 5-ASA suppositories, despite poor compliance. Biologics or other immunosuppressive treatments were needed in 37% of patients. Close follow-up with adjustment of treatment should be considered in children with UP as its clinical course varies.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1902-1909"},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Autologous Regulatory T-Cell Therapy Ameliorates DSS-Induced Colitis in Humanized Mice.","authors":"Md Jabed Khan, Yoo Jin Lee, Su Yeon Lee, Hyeyeon Chung, Thuy Nguyen-Phuong, Yong-Hee Kim, Chung-Gyu Park, Young Mo Kang","doi":"10.1093/ibd/izaf141","DOIUrl":"https://doi.org/10.1093/ibd/izaf141","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic inflammatory disorder with a complex immune-mediated pathogenesis. The efficacy of human-specific cellular immunotherapies and biological medications cannot be accurately evaluated using traditional murine IBD models. Therefore, a humanized mouse model of IBD is necessary. Regulatory T cells (Tregs) are critical for maintaining intestinal immune homeostasis and may have therapeutic potential for treating IBD.</p><p><strong>Methods: </strong>Donor peripheral blood mononuclear cells (PBMCs) were used to reconstitute the human immune system in NOG mice and for Treg isolation. T cells were sorted and stimulated with anti-CD3 and anti-CD28 in the presence of irradiated feeder cells to prepare Treg cells. Two weeks after PBMC reconstitution in NOG mice, colitis was induced with dextran sodium sulfate (DSS). The expanded Treg cells were administered intravenously. Ozanimod was used as a positive control.</p><p><strong>Results: </strong>After expansion, 65.4% of the live CD4+ cells were Foxp3+CD25+ Treg cells and 14.5% were non-Treg cells. The mean human leukocyte (hCD45+) engraftment rate in the humanized mice was 56.5% ± 4.5%. Autologous Treg-cell therapy significantly reduced the disease activity index by 78% on day 7. Colonic length was preserved, and colonic inflammation was reduced in mice treated with Treg cells. Immunohistology revealed reduced human T-cell infiltration in Treg-treated mice.</p><p><strong>Conclusions: </strong>Autologous Treg therapy ameliorated the symptoms of DSS-induced colitis in a humanized mouse model. The autologous PBMC-humanized DSS-induced colitis model may serve as a robust preclinical platform for evaluating the efficacy of personalized Treg cell therapy for IBD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}