Inflammatory Bowel Diseases最新文献

{"title":"Bowel Wall Thickness Cutoff Value for Assessing Inflammatory Bowel Disease Activity Using Intestinal Ultrasonography in Children.","authors":"Laura Räisänen, Ray Lang, Michael Couper, Peter Lewindon","doi":"10.1093/ibd/izaf298","DOIUrl":"10.1093/ibd/izaf298","url":null,"abstract":"<p><strong>Background and aims: </strong>Intestinal ultrasonography (IUS) is a noninvasive tool for assessing bowel inflammation. In adults, a bowel wall thickness (BWT) cutoff of 0.30 cm is used to indicate inflammation, but children do not have a widely accepted value. We propose an optimal BWT cutoff value for children.</p><p><strong>Methods: </strong>We performed 144 IUS examinations during 2019-2024 in 133 children within 30 days before to 7 days after colonoscopy. Assessed values for the BWT from the terminal ileum to the rectum were paired with colonoscopy findings at each segment (n = 809 pairs). The cutoff value for detecting inflammation was explored with receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>In children ≥6 years old IUS demonstrated excellent accuracy for detecting moderate/severe inflammation (area under the curve [AUC] 0.907) but poor accuracy for mild inflammation (AUC 0.690) or in children <6 years old (AUC, 0.667). The adult cutoff (0.30 cm) missed 32% of inflammation in children. In children ≥6 years old, a BWT cutoff of 0.27 cm detected 85% of moderate/severe and 43% of mild inflammation. Lower cutoff values (0.24 cm) were more optimal for girls and children weighing <40 kg.</p><p><strong>Conclusions: </strong>Although IUS is an excellent tool for detecting moderate/severe bowel inflammation, this method showed limited accuracy in children <6 years old. The adult BWT cutoff missed over 30% of bowel inflammation in children. BWT cutoff of 0.27-0.30 cm in boys and 0.23-0.25 cm in girls and/or children <40 kg indicated active gut inflammation.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"730-739"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699892","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":"Characterization of mesocolic adipose hyperplasia in a rat 2,4,6-trinitrobenzenesulfonic acid colitis model and comparison to creeping fat in Crohn disease.","authors":"Laura Clua, Roger Suau, Montserrat Guasch, Diandra Monfort-Ferré, Albert Boronat-Toscano, Micaella Aquino, Karol Matute-Molina, Mireya Jimeno, Míriam Mañosa, Lauro Sumoy, Eugeni Domènech, Ramon Bartolí, Josep Manyé, Carolina Serena","doi":"10.1093/ibd/izaf328","DOIUrl":"10.1093/ibd/izaf328","url":null,"abstract":"<p><strong>Background: </strong>Creeping fat (CrF) has emerged as a key pathological feature of Crohn disease (CD). Available data suggest that microbial translocation in CD may trigger CrF development, potentially exacerbating intestinal inflammation and disrupting homeostasis. However, the role of CrF in disease progression remains poorly understood, raising the need for experimental models.</p><p><strong>Methods: </strong>Colitis was induced using 2,4,6-trinitrobenzenesulfonic acid (TNBS) in Sprague-Dawley rats kept in conventional housing conditions. Colonoscopy and weight follow-up observations were performed 3 and 5 days after colitis induction. Samples were collected at day 5 for histopathological staining and cytokine gene expression analyses.</p><p><strong>Results: </strong>Mesocolic adipose hyperplasia resembling CrF-like mesentery was present in both male and female TNBS-treated rats, with no significant sex-related variation in prevalence. Endoscopic evaluation revealed that only TNBS-treated rats with a colonoscopic score greater than 7 (out of 9) exhibited a significant presence of a CrF-like mesentery. Furthermore, a strong correlation was observed between the severity of colonic inflammation and the presence of CrF-like mesentery, including hyperplastic adipocytes, increased immune cell infiltration, and fibrosis. Molecular characterization showed an upregulation of key inflammatory cytokines-interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α-and the pathogen-recognition receptors-Toll-like receptor 2 (TLR2) and nucleotide-binding oligomerization domain-containing protein 2 (NOD2)-in the CrF-like mesocolon, as observed in human CrF. Finally, animals exhibiting CrF-like mesocolon showed a translocation of Gram-positive cocci in the subserosal layer.</p><p><strong>Conclusions: </strong>Mesocolic hyperplasia, closely replicating the key histopathological and molecular features of CD-related CrF, developed in half of the rats in this model. This model provides a cost-effective platform for studying the interplay between intestinal inflammation and mesenteric adipose tissue remodeling.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"610-619"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219598","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":"A methodological concern regarding small-sample propensity score matching and overfitting in the study of postoperative biologic strategies for Crohn's disease.","authors":"Jiajia Xia, Yingzhe Zhang","doi":"10.1093/ibd/izag024","DOIUrl":"10.1093/ibd/izag024","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"838"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456863","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":"A Real-World Longitudinal Case-Study Implementing Digital Screening and Treatment for Distress in Inflammatory Bowel Disease: The COMPASS-IBD Patient Journey.","authors":"Annie S K Jones, Natasha Seaton, Sophie Harding, Alexa Duff, Joanna Hudson, Abigail Wroe, Sam Norton, Harinder Singh, Jemima Onih, Rona Moss-Morris","doi":"10.1093/ibd/izaf259","DOIUrl":"10.1093/ibd/izaf259","url":null,"abstract":"<p><strong>Background: </strong>Comorbid psychological distress (anxiety and depression) in inflammatory bowel disease (IBD) is common and associated with poorer outcomes and increased healthcare burden. Scalable and accessible integrated care is needed. This study examined the feasibility of implementing routine digital mental health screening and digital cognitive-behavioral therapy (COMPASS-IBD) for psychological distress in a large IBD service.</p><p><strong>Methods: </strong>During implementation, distress was identified by screening or IBD clinician referral. Further triage determined eligibility to receive COMPASS-IBD with trainee therapist support (12 weeks). Pre- and post-intervention outcomes examined reach, acceptability, implementation, and potential effectiveness of the new pathway.</p><p><strong>Results: </strong>Screening was completed by 827 patients (from November 2022 to September 2023), with 196 patients meeting clinical cutoffs and referred for IBD psychology triage. An additional 82 patients were directly referred via IBD clinicians. Of 91 eligible patients, 65 (71.4%) were enrolled into COMPASS-IBD. Distress significantly reduced post-intervention (Patient Health Questionnaire Anxiety and Depression Scale = -6.203; 95% confidence interval, -8.76 to -3.64; P < .001; Cohen's d = -0.553). Symptoms of anxiety, depression, and IBD-related quality of life significantly improved, but IBD symptomatology did not. Full adherence (≥5 online and ≥3 therapist sessions) to COMPASS-IBD was completed by 32.3% of patients. After initially increasing, the IBD psychology waitlist decreased in wait time (30.8%) and number (63.4%) by the end of study implementation. Patients were accepting of the new treatment pathway.</p><p><strong>Conclusions: </strong>Routine mental health screening and COMPASS-IBD were successfully implemented in an outpatient IBD service, but support from trainee psychologists and the research team was required. This new integrated pathway can identify and treat psychological distress in IBD with minimal service resource.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"620-633"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959121","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":"Real-World Effectiveness of and Optimization Strategies for Mirikizumab in Pediatric Ulcerative Colitis: A Prospective, Observational Study.","authors":"Keisuke Jimbo, Nobuyasu Arai, Mitsuyoshi Suzuki, Emiko Suzuki, Musashi Hibio, Masumi Nagata, Masamichi Sato, Eri Miyata, Eri Hoshino, Takahiro Kudo, Hiromichi Shoji","doi":"10.1093/ibd/izaf291","DOIUrl":"10.1093/ibd/izaf291","url":null,"abstract":"<p><strong>Background: </strong>Real-world evidence for mirikizumab (MIRI) in pediatric ulcerative colitis (UC) is limited. We evaluate the real-world effectiveness, remission kinetics, and optimization strategies for MIRI in pediatric UC.</p><p><strong>Methods: </strong>This prospective cohort study included Japanese children with UC receiving intravenous MIRI (300 mg at weeks 0, 4, 8), followed by subcutaneous maintenance (200 mg every 4 weeks). Those without clinical remission (CR; Pediatric Ulcerative Colitis Activity Index [PUCAI] < 10 plus intestinal ultrasonographic [IUS] remission) by week 12 underwent prolonged intravenous induction every 4 weeks until week 24. Outcomes included CR, symptomatic remission (SR), ultrasonographic remission (UR), and endoscopic remission (ER).</p><p><strong>Results: </strong>Twenty-eight children were included (median age 13 years; 50% female; median PUCAI 67.5; 67.4% biologics-naive). All remission measures improved by week 12 (P < 0.001). Median time to CR was 10 (interquartile range 4-16) weeks; durable CR occurred in 27/28 (96.4%). From weeks 12 to 52, CR, UR, and ER continued increasing, whereas SR plateaued. Prolonged induction delayed median CR (16 vs 8 weeks) but most patients achieved remission by week 52. On multivariate analysis, prolonged induction was the sole independent predictor of delayed CR, whereas prior biologic exposure was not. Early IUS findings differentiated patients requiring prolonged induction or with prior biologic exposure. No serious adverse events occurred, and MIRI was well tolerated.</p><p><strong>Conclusions: </strong>MIRI can induce and sustain CR in pediatric UC, particularly when early optimization strategies are applied. These findings highlight IUS as a useful surrogate for mucosal healing and support MIRI as a promising, adaptable, and safe therapeutic option in pediatric UC.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"711-720"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540482","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":"Risk Factors and Management of Incomplete Microscopic Colitis: A Systematic Review and Meta-Analysis.","authors":"June Tome, Raseen Tariq, Cynthia J Chelf, Rondell P Graham, Sahil Khanna, Darrell S Pardi","doi":"10.1093/ibd/izaf257","DOIUrl":"10.1093/ibd/izaf257","url":null,"abstract":"<p><strong>Background: </strong>The term \"incomplete microscopic colitis\" (MCi) has been suggested to define patients with chronic watery diarrhea not fulfilling the complete histologic criteria for MC. There are inconsistent data on the epidemiology of MCi and the optimal management of these patients.</p><p><strong>Methods: </strong>A systematic search of randomized control trials (RCTs) and observational studies of adults with biopsy-proven MCi (incomplete lymphocytic colitis and collagenous colitis) was conducted using Cochrane, Medline, Scopus, and Embase from inception to May 6, 2025. Data were extracted on (1) incidence and prevalence of MCi, (2) patient features and risk factors, (3) clinical response with treatment, and (4) relapse after treatment cessation. Data were pooled using the random-effects model to calculate weighted pooled estimates and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 136 potentially relevant publications identified, 49 passed abstract screening, and 17 studies (1 RCT and 16 observational) were included, with a total of 1370 patients with MCi (median age of 62 years and 69.6% women). The incidence rate of MCi ranged from 0.96 to 5.0 cases per 100 000 person-years. The pooled proportion of concurrent autoimmune disease with MCi was 18% (95% confidence interval [CI], 0.07-0.28; I2 = 95%), and 46% (95% CI, 0.28-0.64; I2 = 95%) were on medications associated with microscopic colitis (MC). The pooled clinical remission rate with any induction therapy was 78% (95% CI, 0.68-0.89; I2 = 81%) and 85% (95% CI, 0.72-0.98; I2 = 88%) with budesonide.</p><p><strong>Conclusions: </strong>Patients with MCi share similar characteristics with full MC including demographics, risk factors, and response to therapy, indicating that the histologic criteria for MC should potentially be broadened.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"765-774"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145632927","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":"Clinical Characteristics and Treatment Patterns in a Large Cohort of Patients with Metastatic Crohn's Disease.","authors":"Natalie M Baker, Karla Santiago Soltero, Joseph Ebriani, Rahul S Dalal, Alexandra P Charrow","doi":"10.1093/ibd/izaf164","DOIUrl":"10.1093/ibd/izaf164","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"824-825"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952708","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":"Characterizing Healthcare Disparities, Utilization, and Trends of Inflammatory Bowel Disease in Transgender and Nonbinary Patients: A Population-Based Study.","authors":"Andrew Suchan, Lara Chaaban, Lynn Kobeissi, Bashar A Hassan, Fan Liang, Sowmya Sharma, Joanna M Melia","doi":"10.1093/ibd/izaf266","DOIUrl":"10.1093/ibd/izaf266","url":null,"abstract":"<p><strong>Background: </strong>Transgender and nonbinary (TGNB) individuals comprise 0.5% to 0.6% of the U.S. population and face significant healthcare disparities, yet little is known about inflammatory bowel disease (IBD) in this group. We aimed to characterize IBD prevalence, comorbidities, healthcare utilization, and the impact of hormone replacement therapy (HRT) in TGNB individuals.</p><p><strong>Methods: </strong>Using TriNetX, we analyzed (1) IBD prevalence among TGNB adults, (2) comparisons of IBD patients who are and who are not TGNB, and (3) comparisons of TGNB IBD patients with and without HRT. Outcomes included demographics, comorbidities, laboratory markers, healthcare encounters, IBD treatment, and cardiovascular and thrombotic events.</p><p><strong>Results: </strong>Of 111 227 TGNB patients, prevalence of Crohn's disease and ulcerative colitis was 0.508% and 0.448%, respectively, increasing with age. TGNB patients were younger (32.5 years of age vs 46.9 years of age; P < .001), exhibited higher rates of gastrointestinal and psychiatric comorbidities, and had more outpatient, emergency, and hospital visits, yet they underwent fewer endoscopies (25.7% vs 30.7% risk; P = .011) and were less likely to receive targeted IBD therapy than cisgender patients. Patients with HRT had more outpatient encounters (66.7% vs 58.2%; P = .010) and were more likely to use therapies like mesalamine (12.4% vs 7.6%; P = .021) than those without HRT. There were no significant differences in laboratory markers or thrombotic or cardiovascular events in these analyses.</p><p><strong>Conclusions: </strong>TGNB IBD patients experience greater gastrointestinal and psychiatric comorbidities and receive fewer interventions overall despite greater healthcare contact. HRT was not associated with worsening disease or complications. These findings highlight critical disparities and the need for further research in this population.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"643-649"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762712","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":"Pregnancy and Maternal Outcomes After Exposure to Risankizumab During Pregnancy: A Multi-Center Experience in the United States.","authors":"Rachel W Winter, Liang-Yin Tao, Sonia Friedman, Kevin Sheng-Kai Ma","doi":"10.1093/ibd/izaf310","DOIUrl":"10.1093/ibd/izaf310","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"820-823"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827618","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":"Considerations regarding the use of computer-aided detection in IBD surveillance colonoscopy.","authors":"Yasuharu Maeda, Shin-Ei Kudo, Masashi Misawa","doi":"10.1093/ibd/izag013","DOIUrl":"10.1093/ibd/izag013","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"836-837"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194478","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}