Inflammatory Bowel Diseases最新文献

{"title":"Genome-Wide Aggregated Trans-Effects Analysis Implicates Deficient Type III Interferon Signaling as a Key Cause of Inflammatory Bowel Disease.","authors":"Paul M McKeigue, Andrii Iakovliev, Buddhiprabha Erabadda, Helen M Colhoun, Athina Spiliopoulou","doi":"10.1093/ibd/izaf214","DOIUrl":"https://doi.org/10.1093/ibd/izaf214","url":null,"abstract":"<p><strong>Background: </strong>Genome-wide association studies of inflammatory bowel disease have identified hundreds of common genetic variants that are associated with inflammatory bowel disease, but few promising therapeutic targets. The \"omnigenic\" sparse effector hypothesis postulates that the polygenic effects of common SNPs on a typical complex trait are mediated by trans-effects that coalesce on the expression of a sparse set of core genes. The objective of this study was to identify core genes for inflammatory bowel disease.</p><p><strong>Methods: </strong>Using summary statistics from studies of transcript levels in whole blood or proteins in plasma, we constructed genome-wide aggregated trans-effects (GATE) scores for predicted gene expression in the UK Biobank cohort and tested these scores for association with inflammatory bowel disease (7949 cases, 452 790 noncases).</p><p><strong>Results: </strong>Inflammatory bowel disease was inversely associated with GATE scores for 5 interferon-stimulated genes-IFIT1, IFI44, HERC5, MX1, IFI44L-regulated by the same trans-expression quantitative trait locus, and with the GATE score for IFNL1. For 6 other genes, GATE score associations with inflammatory bowel disease were supported by other criteria: reported associations with nearby genetic variants, perturbation in experimental models, association with measured protein levels, or drug effects.</p><p><strong>Conclusions: </strong>These results implicate down-regulation of Type III interferon signaling as a core pathway in the etiology of inflammatory bowel disease, supported by reports of monogenic inflammatory bowel disease caused by rare loss-of-function variants and by perturbation in experimental models of colitis. Deficient Type III interferon signaling may be amenable to therapeutic intervention.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149018","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 Fistulizing Crohn's Disease in Children at Diagnosis: A Cross-Sectional Study.","authors":"Yi Fan Lin, Alicia Truchon, Boris Djoukam Mbuko, Huan Yu Lily Dai, Samuel Sassine, Amélie Damphousse, Sébastien Benali, Mona Beaunoyer, Colette Deslandres, Prévost Jantchou","doi":"10.1093/ibd/izaf220","DOIUrl":"https://doi.org/10.1093/ibd/izaf220","url":null,"abstract":"<p><strong>Background: </strong>Perianal manifestations are common at diagnosis of Crohn's Disease and include perianal fistulas, abscesses, fissures, and inflammatory anal skin tags. Perianal fistulizing Crohn's disease (PFCD), involving fistulas and abscesses, is associated with a poor prognosis in children.This study aimed to identify the factors associated with PFCD at diagnosis. Secondary aims were to: assess factors associated with the severity of PFCD according to the Van Assche score, characterize the prevalence of perianal Crohn's disease in a Canadian cohort, and evaluate its management at diagnosis.</p><p><strong>Methods: </strong>We collected data from patients aged 4-18 years diagnosed with Crohn's disease between 2009 and 2021 at our IBD center who underwent perineal magnetic resonance imaging within three months of diagnosis. Perianal Crohn's disease was assessed clinically and through MRI results.</p><p><strong>Results: </strong>Among 489 patients (57.9% male, median age 13.8 years), 229 (46.8%) had perianal Crohn's disease. Perianal fistulizing Crohn's disease was identified in 115 patients (23.5%), including 13.0% without any clinical signs. The median Van Assche score was 13.0 in patients with PFCD versus 2.0 in those without. Male sex, granulomas on intestinal biopsies, and anal fissures were associated with both the presence and increased severity of PFCD.</p><p><strong>Conclusion: </strong>This study emphasizes the importance of performing perianal MRI early at the diagnosis as occult perianal fistulizing Crohn's disease may be discovered. Male sex, granulomas on intestinal biopsies and anal fissures were associated both with the presence of PFCD and increased severity.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137318","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":"Therapeutic Benefit of Upadacitinib in Severe Post-Proctectomy (Class 4) Perianal Crohn's Disease: A Three-Patient Case Series.","authors":"Luke Nathan Hanna, Baseer Quraishi, Theo Pelly, Phillip Lung, Phil Tozer, Ailsa Hart, Serre-Yu Wong, Nick Powell","doi":"10.1093/ibd/izaf216","DOIUrl":"https://doi.org/10.1093/ibd/izaf216","url":null,"abstract":"<p><p>This case series describes striking clinical and radiological responses in 3 Crohn's disease patients with persistent perineal complications following proctectomy treated with upadacitinib. It highlights the potential of advanced therapies for this refractory inflammatory bowel disease phenotype with limited treatment options.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137340","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":"Gut Mycobiome in Inflammatory Bowel Disease: A Systematic Review of Case-Control Studies.","authors":"Johannes D Füchtbauer, Olga Brovkina, Kostas Sivickis, Claus Aalykke, Marte L Høivik, Vibeke Andersen, Jonas Halfvarson, Corinna Bang, Andre Franke, Jens Kjeldsen","doi":"10.1093/ibd/izaf217","DOIUrl":"https://doi.org/10.1093/ibd/izaf217","url":null,"abstract":"<p><strong>Background: </strong>The bacterial composition of the microbiome in inflammatory bowel disease (IBD) has been the focus of substantial interest. In contrast, the fungal part of the microbiome, the mycobiome, has only rarely been investigated-although anti-Saccharomyces cerevisiae antibodies, an antibody against fungal mannan, have been known for years as a biomarker for Crohn's disease (CD), but not for ulcerative colitis (UC).</p><p><strong>Methods: </strong>A systematic review of case-control studies on the human gut mycobiome in IBD was conducted using searches in EMBASE and MEDLINE.</p><p><strong>Results: </strong>Twenty-seven studies, with a total of 1406 IBD patients and 1060 controls were identified. The differences in alpha diversity varied across studies and were related to geography, whereas differences in beta diversity between cases and controls were found in a large majority of the studies. Overall, the results were inconsistent at different taxonomic levels, and the studied populations were heterogeneous, as were the methodological approaches. The most consistent finding was an increase of Candida for both CD and UC and of Malassezia in CD, where it was often linked to a decrease of Saccharomyces.</p><p><strong>Conclusions: </strong>The mycobiome is altered in IBD, as differences in beta diversity were found between cases and controls consistently. Future studies should carefully standardize every step from sample collection through analysis and data processing, allowing external validation of findings. Inclusion of treatment naïve patients and symptomatic controls could further advance this field.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130687","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":"Deciphering Mechanisms Underlying Success of Microbiome-Targeted Diet Therapy in Ulcerative Colitis.","authors":"Levi Teigen","doi":"10.1093/ibd/izaf203","DOIUrl":"https://doi.org/10.1093/ibd/izaf203","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124421","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":"Systematic Review of Available Intestinal Ultrasound Scores for Inflammatory Bowel Disease and Update on Validation Studies.","authors":"Tommaso Innocenti, Carmen Rocco, Luca Scarallo, Paolo Lionetti, Andrea Galli, Gabriele Dragoni","doi":"10.1093/ibd/izaf183","DOIUrl":"https://doi.org/10.1093/ibd/izaf183","url":null,"abstract":"<p><strong>Background: </strong>Various intestinal ultrasound (IUS) scoring systems combining different measurable parameters have been designed for inflammatory bowel disease (IBD), both Crohn's disease (CD) and ulcerative colitis (UC). We aimed to provide an extensive systematic review of all the IUS scores developed for both CD and UC, adding a particular focus on the subsequent validation studies.</p><p><strong>Methods: </strong>For the systematic search, the PubMed and EMBASE databases were screened from their inception until November 15, 2024. All articles proposing IUS scores for patients with IBD, both adults and children, were included.</p><p><strong>Results: </strong>A total of 6381 studies were identified, and 23 studies evaluating 23 scores were finally included in the systematic review. Fifteen and 6 studies included patients with CD and UC, respectively, while 3 included a pediatric IBD population. The gold standard for developing the IUS score was endoscopy in 83% of the studies. The most relevant parameters included into the scores were bowel wall thickness, vascularity, bowel wall stratification, and inflammatory fat. The pooled sensitivity, specificity, and accuracy of the included IUS scores were 68% to 100%, 57% to 100%, and 72% to 91%, respectively, in the development studies. Only 6 of 23 studies assessed the interrater agreement of the developed scores. Thirteen scores out of the 23 included in the systematic review underwent a validation, with only 7 having been validated in more than 2 different cohorts.</p><p><strong>Conclusions: </strong>IUS scoring systems are easy-to-use tools for standardizing communication among sonographers. Recent validation studies for a few scores have confirmed their applicability to daily IBD practice.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102815","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":"Defining Fecal Calprotectin Cutoffs That Predict Endoscopic and Histologic Remission in Patients With Ulcerative Colitis.","authors":"Gustavo Drügg Hahn, Peter Laszlo Lakatos, Chelsea Maedler-Kron, Victoria Marcus, Waqqas Afif, Gary Wild, Alain Bitton, Cristina Flores, Carlos Fernando de Magalhães Francesconi, Talat Bessissow","doi":"10.1093/ibd/izaf008","DOIUrl":"https://doi.org/10.1093/ibd/izaf008","url":null,"abstract":"<p><strong>Background: </strong>Fecal calprotectin is a reliable surrogate marker for disease activity in ulcerative colitis. However, there are no consensus cutoff values for histoendoscopic remission. This study aimed to correlate fecal calprotectin with Mayo endoscopic score and histological disease activity (Geboes score) for ulcerative colitis patients in clinical remission.</p><p><strong>Methods: </strong>Prospective study including adult ulcerative colitis patients in clinical remission or disease relapse, undergoing endoscopy for disease activity or dysplasia surveillance at an inflammatory bowel disease center between 2013 and 2020. Fecal calprotectin was collected before bowel preparation and Mayo endoscopic score was documented during colonoscopy. Biopsies were taken throughout the colon and histological activity was assessed using Geboes score by a blinded expert gastrointestinal pathologist.</p><p><strong>Results: </strong>Two hundred fifty-three patients were included, 117 (46%) were male (mean age of 38.2 years-standard deviation ± 24.8). A fecal calprotectin ≥ 123 μg/g predicts Mayo endoscopic score > 0 (58% sensitivity and 70% specificity), also aiding to differentiate Mayo endoscopic score 0 from 1 (61% sensitivity and 70% specificity). A fecal calprotectin ≥ 80 μg/g identified histological disease activity using Geboes score > 3.1 in patients with clinical remission (64.7% sensitivity, 58.7% specificity). Using Geboes score > 2, a fecal calprotectin ≥ 50 μg/g, is the most clinically relevant to identify patients in clinical remission with active histologic inflammation (49.6% sensitivity, 41.6% specificity).</p><p><strong>Conclusions: </strong>Fecal calprotectin correlates with endoscopic and histologic disease activity and can be used as a surrogate marker for disease activity. Our study prospectively demonstrated optimal cutoff values to discriminate histoendoscopic remission.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091535","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":"Immunomodulators and Advanced Therapies for Induction of Remission in Crohn's Disease: A Systematic Review and Network Meta-Analysis.","authors":"Vasiliki Sinopoulou, Morris Gordon, Shiyao Liu, Daniel Arruda Navarro Albuquerque, Aderonke Ajiboye, Sudheer Kumar Vuyyuru, Shellie Radford, Gordon Moran","doi":"10.1093/ibd/izaf191","DOIUrl":"https://doi.org/10.1093/ibd/izaf191","url":null,"abstract":"<p><strong>Background: </strong>Previous reviews for Crohn's disease (CD) treatment have rarely considered advanced and immunomodulator medical therapies together. Our aim was to compare all therapies for efficacy and safety in induction of remission.</p><p><strong>Methods: </strong>We searched databases up to June 2025. Our outcomes were clinical remission and response, endoscopic remission, and safety outcomes. We performed network meta-analyses and estimated risk ratios (RR) and 95% CIs. We used GRADE to assess certainty of results, and surface under the cumulative ranking curve for ranking treatments.</p><p><strong>Results: </strong>A total of 79 RCTs with 20 724 participants were included. Interventions ranged from 2 to 30 weeks. There was moderate GRADE certainty of effectiveness over placebo for clinical remission for combination of adalimumab with thiopurines (RR, 2.87; 95% CI, 1.99-4.14; RD (Risk difference)  = 35.3%; NNT (Number needed to treat) = 3, large magnitude), guselkumab (RR, 2.5; 95% CI, 1.95-3.21; RD = 28.4%; NNT = 4, moderate magnitude, adalimumab (RR, 2.46; 95% CI, 1.84-3.29; RD = 27.6% NNT = 4, moderate magnitude), combination of infliximab with thiopurines (RR, 2.43; 95% CI, 1.71-3.44; RD = 27%; NNT = 4, moderate magnitude), and ustekinumab (RR, 2.04; 95% CI, 1.69-2.46; RD = 19.6% NNT = 5, small magnitude). For endoscopic remission, there was moderate GRADE certainty of effectiveness for risankizumab (RR, 3.48; 95% CI, 2.18-5.58; RD = 17.4%, moderate magnitude). The certainty on safety varied, but treatments appear generally safe in the short term.</p><p><strong>Conclusion: </strong>Combination of anti-tumor necrosis factors (anti-TNFs) and immunomodulators followed by anti-TNF monotherapy had large effect size with moderate certainty for the induction of clinical remission. More novel therapies appear to have similar effect sizes but with increased imprecision of the estimates.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091524","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":"Diverting Loop Ileostomy as an Alternative to Emergent Colectomy in Acute Severe Ulcerative Colitis Flare following Checkpoint-Inhibitor Therapy.","authors":"Ethan X Tan, Vinna An, Mayur Garg","doi":"10.1093/ibd/izaf187","DOIUrl":"https://doi.org/10.1093/ibd/izaf187","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091546","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":"Comparative Efficacy of Medical Therapies in Reducing the Risk of Postoperative Recurrence in Crohn's Disease: A Systematic Review and Network Meta-Analysis.","authors":"Mohammad Shehab, Omar Alrashed, Fatema Alrashed, Raghad Alyousefi, Amine Zoughlami, Peter Lakatos, Matthieu Allez, Vipul Jairath, Miguel Regueiro, Talat Bessissow","doi":"10.1093/ibd/izaf186","DOIUrl":"https://doi.org/10.1093/ibd/izaf186","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 50% of patients with Crohn's disease (CD) will require surgery, and 70% to 90% experience endoscopic recurrence (ER) within the first year postoperatively. Despite various treatments, there are scant data on their comparative efficacy to prevent recurrence. This study aimed to compare the efficacy of medical treatments in preventing postoperative recurrence of CD.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted through January 2025. We included randomized controlled trials and prospective cohort studies, excluding pediatric studies, single-arm trials, and dose comparison studies. The primary endpoint was assessing ER (Rutgeerts score ≥i2) at 6 months, and secondary outcomes were clinical recurrence (Crohn's Disease Activity Index ≥150, Hanauer score ≥2, or Harvey-Bradshaw Index ≥8) at 6, 12, and ≥18 months postoperatively. Frequentist random-effects network meta-analysis was conducted, reporting odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 42 studies were included, of which 38 were randomized controlled trials, with a total of 2260 patients. At 6 months, adalimumab (ADA) ranked highest in reducing ER (surface under the cumulative ranking curve [SUCRA] = 84.5%), followed by vedolizumab (VDZ) (SUCRA = 74.5%). ADA significantly reduced ER compared with thiopurines (THPs) (OR, 0.33; 95% CI, 0.12-0.91), probiotics (OR, 0.17; 95% CI, 0.03-0.99), and vitamin D (OR, 0.07; 95% CI, 0.01-0.37). VDZ did not significantly differ from THPs, ADA, or metronidazole. At 12 months, infliximab (IFX) (SUCRA= 93%) and ADA (SUCRA = 90%) had the lowest ER, with IFX showing significant reductions compared with THPs, metronidazole, and 5-aminosalicylic acid. Similar findings were observed at 18 months, with IFX and ADA maintaining the lowest ER rates. For clinical recurrence, no significant differences were observed among therapies at 6 months; however, at 12 months, ADA and IFX were superior to most therapies, including THPs and budesonide.</p><p><strong>Conclusion: </strong>Anti-tumor necrosis factor agents, namely ADA and IFX, are the most effective treatments in reducing postoperative recurrence of CD, followed by VDZ. THPs and antibiotics ranked lower than biologics. Nonpharmacological interventions such as curcumin, vitamin D, and probiotics did not demonstrate efficacy in reducing postoperative recurrence.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091573","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}