Inflammatory Bowel Diseases最新文献

{"title":"First Documented Case of Successful Dual Therapy With Upadacitinib and Mirikizumab for Multi-Refractory Ulcerative Proctitis.","authors":"Daniel Robles de la Osa, Nadia Mileva Semrik, Alejandro Mínguez Sabater, Pilar Nos","doi":"10.1093/ibd/izaf113","DOIUrl":"https://doi.org/10.1093/ibd/izaf113","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136329","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":"Intraoperative Autologous Platelet-Rich Stroma Injection as Add-On to Fistula Curettage and Closure of the Internal Orifice Demonstrates a Favorable Outcome in Long-Term in Patients Suffering from Therapy-Refractory Perianal Fistulizing Crohn's Disease.","authors":"Michiel T J Bak, Annemarie C de Vries, Caroline D M Witjes, Jeanine H C Arkenbosch, Roy S Dwarkasing, Joris A van Dongen, Gwenny M Fuhler, Willem Rudolph Schouten, Christien Janneke van der Woude, Oddeke van Ruler","doi":"10.1093/ibd/izaf011","DOIUrl":"https://doi.org/10.1093/ibd/izaf011","url":null,"abstract":"<p><strong>Background: </strong>An injection with autologous platelet-rich stroma (PRS), a combination of stromal vascular fraction and platelet-rich plasma, as an add-on to fistula curretage and closure of the internal orifice proved to be safe and feasible for the treatment of patients with treatment-refractory perianal fistulizing Crohn's disease (pCD). This study aimed to assess the long-term outcomes in patients with pCD treated with autologous PRS injection.</p><p><strong>Methods: </strong>Adult patients with therapy-refractory pCD (failure to anti-tumor necrosis factor [TNF] therapy and/or fistula surgery), who underwent fistula curettage, closure of the internal fistula orifice, and autologous PRS injection in a Dutch tertiary referral center were included in an earlier conducted pilot study (n = 25). The primary outcome was complete clinical closure at long-term follow-up (closure of all treated external opening[s]). Secondary outcomes were partial clinical closure (closure of ≥1 treated external opening[s]), radiologic healing (fibrotic fistula tract on magnetic resonance imaging), and recurrence.</p><p><strong>Results: </strong>The majority of the patients were female (56%) (mean age 34.4 years [standard deviation - SD: 0.9], and mean follow-up 3.7 years [SD: 0.6]). The treatment-refractory character of the study cohort was displayed by the high rate of patients with ≥1 external opening (60%), prior exposure to an anti-TNF agent (92%), TOpClass classification system ≥ class 2b (36%), and the low rate of patients who underwent prior surgical interventions aimed at fistula closure (12%). During long-term follow-up, complete clinical closure was achieved in 88%. Partial clinical closure was achieved in all patients. Radiologic healing was achieved in 75% of the patients. Recurrence was reported in 8% of the patients who achieved prior clinical closure. No recurrences were observed in patients with radiologic healing. Seventeen unplanned re-interventions were reported in nine patients (36%), predominantly for residual fistulizing disease and in patients with severe therapy-refractory pCD (TOpClass classification system ≥ class 2b) at the time of inclusion.</p><p><strong>Conclusion: </strong>Additional PRS injection, fistula curettage, and closure of the internal orifice is a promising therapy for patients with (treatment-refractory) pCD and could improve clinical and radiologic healing rates. In addition, low recurrence rates were observed. Future randomized research is warranted in order to assess the effectiveness and positioning of PRS in the field of pCD.</p><p><strong>Clinical trial registration: </strong>NL8417.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135886","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":"Structural Bowel Disease: Not a Barrier to Transmural Healing With IUS.","authors":"John P Haydek","doi":"10.1093/ibd/izaf114","DOIUrl":"https://doi.org/10.1093/ibd/izaf114","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136061","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":"Incidence and Risk Factors for Development of Acne (JAKne) in Patients with Inflammatory Bowel Disease Treated With Upadacitinib.","authors":"David Choi, Amelia Kellar, Jeremy Klein, Natalie K Choi, Nicole M Garcia, Scott Friedberg, David T Rubin","doi":"10.1093/ibd/izaf115","DOIUrl":"https://doi.org/10.1093/ibd/izaf115","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136330","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":"Plasma Calprotectin and Myeloperoxidase as Biomarkers in Inflammatory Bowel Disease.","authors":"Duo Hou, Akhilesh Swaminathan, Grace M Borichevsky, Chris M Frampton, Antony J Kettle, Richard B Gearry","doi":"10.1093/ibd/izaf110","DOIUrl":"https://doi.org/10.1093/ibd/izaf110","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a relapsing-remitting illness requiring proactive monitoring of gut inflammation. We aimed to determine the correlations of plasma myeloperoxidase (pMPO) and calprotectin (pCal), two neutrophil proteins, with existing measures of disease activity.</p><p><strong>Methods: </strong>Adults with IBD undergoing ileocolonoscopy were recruited prospectively. Baseline assessments included blood tests (pMPO, pCal, and C-reactive protein ([CRP]), symptom questionnaires, and endoscopic indices (simple endoscopic score for CD [SES-CD] and UC endoscopic index of severity [UCEIS]). Active IBD was defined as SES-CD > 2 and UCEIS ≥ 2. Spearman's rank correlations assessed the associations between blood markers and endoscopic activity. The area under the receiver operating characteristics curves (AUROC) and univariable logistic regression assessed the ability of blood markers (at optimal thresholds) to identify active disease.</p><p><strong>Results: </strong>In total, 170 participants were included (female, n = 92; Crohn's disease [CD], n = 99; median age 46 years, IQR 35-58). Plasma biomarkers more accurately identified active IBD in individuals with UC (AUROCpMPO = 0.76, P < .001; AUROCpCal = 0.66, P < .05; AUROCCRP = 0.73, P < .001) than in CD (AUROCpMPO = 0.62, P > .05; AUROCpCal = 0.65, P < .01; AUROCCRP = 0.66, P < .01). In all patients with IBD, the addition of pCal (AUROC = 0.73, P < .001) and pMPO (AUROC = 0.73, P < .001) to CRP added benefit compared to CRP (AUROC = 0.70, P < .001) alone. Plasma myeloperoxidase > 13.86 ng/mL (odds ratio [OR] = 10.13, 3.4-30.16) and pCal > 961.72 ng/mL (OR = 3.38, 1.21-9.4) were associated with an increased odds of having endoscopically active UC.</p><p><strong>Conclusions: </strong>Plasma MPO shows promise as a potential blood-based biomarker of IBD activity, especially in UC. The combined use of pMPO and CRP adds diagnostic utility in discriminating between active versus quiescent IBD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135920","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":"Rectal and Rectosigmoid Endoscopy to Assess Endoscopic and Histological Remission in Ulcerative Colitis: A Prospective Study.","authors":"Clara Yzet, Capucine Moreau, Denis Chatelain, Erica Meudjo, Franck Brazier, Vincent Hautefeuille, Camille Robert, Catherine Decrombecque, Ruxandra Sarba, Raphaël Pichois, Audrey Michaud, Mathurin Fumery","doi":"10.1093/ibd/izaf094","DOIUrl":"https://doi.org/10.1093/ibd/izaf094","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite increasing interest in endoscopic and histological remission as a treatment target in ulcerative colitis (UC), the accuracy of endoscopic and histological findings in the left colon and/or rectum to detect pancolonic remission is poorly known. We aimed to compare the diagnostic accuracy of rectosigmoidoscopy (RS) and rectoscopy for detecting endoscopic and histological healing elsewhere in the colon.</p><p><strong>Methods: </strong>Consecutive UC patients who underwent colonoscopy were prospectively included. Endoscopic healing was defined by a Mayo endoscopic score (MES) = 0 on all explored segments and histological healing was defined by a Nancy index ≤ 1 (2 biopsies/segments). The agreement between colonoscopy, RS, and rectoscopy for endoscopic and histological healing was assessed using Cohen's kappa coefficient.</p><p><strong>Results: </strong>Eighty patients were included. Thirty-four had an MES = 0 by RS and colonoscopy. The agreement between colonoscopy and RS was almost perfect, with a к index of 0.95 (%-agree 97.5) for Mayo 0, and к of 0.95 for Mayo 0-1 (%-agree 97.5, P < .0001). The agreement between RS and colonoscopy was also almost perfect (к = 0.877, (%-agree 91.7, P < .001) for the assessment of histological healing. The agreement between rectoscopy and colonoscopy for the evaluation of endoscopic (Mayo 0) and histological healing was almost perfect as well (к = 0.83 (%-agree 91.2, P < .001) and к = 0.80 (%-agree 91.7, P < .001)).</p><p><strong>Conclusion: </strong>For UC patients undergoing treat-to-target interventions, endoscopic and histological findings in the rectum alone provide good accuracy for determining pancolonic endoscopic and histological remission. Rectal examination could be an alternative to RS for monitoring UC patients.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135925","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":"Myeloperoxidase Enzyme Activity in Feces Reflects Endoscopic Severity in Inflammatory Bowel Disease.","authors":"Grace M Borichevsky, Akhilesh Swaminathan, Briana R Smith, Teagan S Edwards, Louisa V Ashby, Chris M A Frampton, Andrew S Day, Richard B Gearry, Anthony J Kettle","doi":"10.1093/ibd/izaf109","DOIUrl":"https://doi.org/10.1093/ibd/izaf109","url":null,"abstract":"<p><strong>Background: </strong>Concentrations of the neutrophil protein myeloperoxidase are elevated in the feces of individuals with endoscopically active inflammatory bowel disease (IBD). Its enzyme activity could give an immediate readout of endoscopic inflammation. We investigated whether fecal myeloperoxidase activity (fMPOa) is associated with IBD endoscopic inflammation. We also investigated whether myeloperoxidase promotes oxidative stress in IBD.</p><p><strong>Methods: </strong>Myeloperoxidase enzyme activity was measured using an enzyme-linked immunosorbent assay (ELISA fMPOa), a novel CM-sepharose extraction assay (CM-S fMPOa), or by quantifying urinary glutathione sulfonamide (GSA) by tandem mass spectrometry. GSA is a specific biomarker of myeloperoxidase activity. IBD activity was assessed using the ulcerative colitis endoscopic index of severity or the simple endoscopic score for Crohn's disease (SES-CD). Spearman's correlation and receiver operating characteristic curves evaluated biomarker utility.</p><p><strong>Results: </strong>IBD patients (n = 172) were recruited prospectively (ulcerative colitis, n = 72; Crohn's disease, n = 100). fMPO was mostly active. Its enzyme activity, measured either as ELISA fMPOa or CM-S fMPOa, correlated with endoscopic inflammation in both ulcerative colitis and Crohn's disease. Urinary GSA is also correlated with endoscopic disease inflammation. Correlations of urinary GSA with disease measures and other biomarkers were stronger in ulcerative colitis than in Crohn's disease.</p><p><strong>Conclusions: </strong>Myeloperoxidase is active in IBD and its enzyme activity is a reliable marker of IBD endoscopic inflammation. Our results with the CM-S fMPOa assay demonstrate the potential for an immediate and accurate measure of fMPO enzyme activity as a robust, low-cost test for IBD activity. Myeloperoxidase may contribute to tissue damage in IBD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135897","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":"Unravelling the Relationship Between Obesity and Inflammatory Bowel Disease.","authors":"Jessica Sun, Ella C Brooks, Yashar Houshyar, Susan J Connor, Gokulan Paven, Michael C Grimm, Georgina L Hold","doi":"10.1093/ibd/izaf098","DOIUrl":"https://doi.org/10.1093/ibd/izaf098","url":null,"abstract":"<p><p>Mirroring the global obesity epidemic, obesity rates in inflammatory bowel disease (IBD) patients is rising. Several epidemiological studies propose that 15%-40% of adult patients with IBD are obese, and an additional 25%-40% fall into the overweight category. This article examines the pathophysiologic relationship between obesity and IBD concerning the role of visceral adipose tissue, microbiota shifts, dietary patterns, and hunger hormone changes. Additionally, increasing evidence is demonstrating the negative impact that obesity is having on disease course and quality of life in patients with IBD. Obesity has been demonstrated to be associated with an attenuated response to immunomodulators and biological agents, as well as higher rates of peri-operative surgical complications. A better understanding of the relationship between obesity and IBD can be applied to clinical decision-making in personalizing treatment plans, promoting weight loss in patients with obesity, and identifying areas of future research.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110796","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":"Usefulness of Prostaglandin E-Major Urinary Metabolite in Monitoring Crohn's Disease Activity: A Prospective Cross-Sectional Study.","authors":"Natsuki Ishida, Satoshi Tamura, Tomohiro Takebe, Kenichi Takahashi, Yusuke Asai, Tomoharu Matsuura, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Takanori Yamada, Satoshi Osawa, Ken Sugimoto","doi":"10.1093/ibd/izaf025","DOIUrl":"https://doi.org/10.1093/ibd/izaf025","url":null,"abstract":"<p><strong>Background: </strong>The goal of treatment for Crohn's disease (CD) is to achieve mucosal or transmural healing, and biomarker measurements are useful in monitoring disease activity and guiding treatment. This study aimed to investigate the utility of a new urinary biomarker, prostaglandin E-major urinary metabolite (PGE-MUM), in assessing CD activity.</p><p><strong>Methods: </strong>The study involved 87 patients with CD who underwent endoscopic examination and measurements of 4 biomarkers: Prostaglandin E-major urinary metabolite, fecal calprotectin (FC), leucine-rich α2 glycoprotein (LRG), and C-reactive protein (CRP). Endoscopic activity was assessed by the Simple Endoscopic Score for Crohn's Disease (SES-CD). Correlations between the CD activity index (CDAI) and SES-CD with the 4 biomarkers were analyzed, and receiver-operating characteristic (ROC) analyses were performed to predict SES-CD ≧ 3.</p><p><strong>Results: </strong>All 4 biomarkers showed significant correlations with both CDAI and SES-CD. The cutoff (area under the curve [AUC]) values for predicting SES-CD ≥ 3 were as follows: PGE-MUM, 25.2 µg/g Cr (0.800); FC, 257 mg/kg (0.816); LRG, 11.8 µg/mL (0.748); and CRP, 0.22 mg/dL (0.656). Subgroup analysis revealed significant correlations between PGE-MUM and SES-CD in both the L1 (small intestine only) and L2 + L3 (including large intestine) groups, with correlation coefficients of 0.654 and 0.586, respectively. In the L1 group, ROC analysis revealed that, among the 4 biomarkers, PGE-MUM had the highest AUC for predicting SES-CD ≥ 3, with a cutoff (AUC) of 33.1 µg/g Cr (0.861).</p><p><strong>Conclusions: </strong>PGE-MUM is a biomarker that can reflect endoscopic activity in patients with CD and may be particularly useful in small intestinal lesions.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110811","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":"SPH3127 (Sitokiren), a Novel Renin Inhibitor, Suppresses Colitis Development in Mouse Models of Experimental Colitis.","authors":"Weicheng Liu, Lei Wang, Caleb Muefong, Wei Su, Xuesong Wang, Rajesh Sarkar, Jing Zhang, Kenneth W Locke, Guangxin Xia, Xin Nakanishi, Yan Chun Li","doi":"10.1093/ibd/izaf097","DOIUrl":"https://doi.org/10.1093/ibd/izaf097","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence suggests that the renin-angiotensin system plays an important role in the pathogenesis of inflammatory bowel disease, but few studies have directly assessed the therapeutic effect of renin inhibitors on colitis development.</p><p><strong>Method: </strong>Experimental colitis was induced in wild-type C57BL/6 mice and renin transgenic (RenTg) mice by 2,4,6-trinitrobenzene sulfonic acid (TNBS). Following intrarectal TNBS instillation, the mice were treated with SPH3127 (sitokiren), a small-molecule renin inhibitor, twice a day by intraperitoneal injection or oral gavage. The therapeutic effect of SPH3127 was evaluated by assessing clinical symptoms, histological injuries, and colonic mucosal inflammatory parameters in these mice.</p><p><strong>Results: </strong>SPH3127 treatment by either delivery route markedly attenuated body weight loss, reduced clinical severity, alleviated colon mucosal ulceration in both C57BL/6 and RenTg mice, and prevented animal death in the case of RenTg mice. SPH3127 treatment blocked the local induction of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, IFN-γ, IL-17) and promoted the production of anti-inflammatory cytokine IL-10 in the colon. Fluorescence-activated cell sorting analysis revealed that SPH3127 substantially diminished the accumulation of TH1 and TH17 cells in the colonic mucosa and confirmed that SPH3127-induced IL-10 production from mucosal CD25+ T cells in the mice.</p><p><strong>Conclusions: </strong>These results demonstrate that SPH3127 is able to effectively block colitis development in mouse experimental colitis models. Its anti-colitogenic activity is achieved at least in part by suppressing mucosal TH1 and TH17 activation while promoting IL-10 production from mucosal CD25+ T cells, thus forming an anti-inflammatory environment in the colonic mucosa.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110790","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}