Intestinal Research最新文献

{"title":"Evidence-based clinical practice guidelines for diagnosis and medical management of acute colonic diverticulitis developed by the Korean Association for the Study of Intestinal Diseases (KASID).","authors":"Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Myung-Won You, Kyuwon Kim, Kwang Woo Kim, Yuna Kim, Seong-Eun Kim, Seung-Jae Myung","doi":"10.5217/ir.2025.00299","DOIUrl":"10.5217/ir.2025.00299","url":null,"abstract":"<p><p>Acute colonic diverticulitis is a common gastrointestinal inflammatory disorder. The incidence of acute colonic diverticulitis has been steadily increasing in Korea, particularly among younger and middle-aged adults. This rising prevalence, along with the observed differences in clinical characteristics compared to Western populations, underscores the need for region-specific, evidence-based guidance. The Korean Association for the Study of Intestinal Diseases (KASID) established a task force to develop these clinical practice guidelines to optimize the diagnosis and medical management of acute colonic diverticulitis tailored to the Korean healthcare environment. These guidelines were developed through a systematic literature review, critical appraisal of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, and expert consensus via a modified Delphi method. They addressed 12 clinical questions encompassing prognostic factors, diagnostic modalities, initial management for uncomplicated diverticulitis, management of complications, and prevention of recurrence. The resulting recommendations provide clinicians with evidence-based guidance for individualized management based on patients' condition and values. These guidelines aim to enhance the quality of care and optimize outcomes for patients with acute colonic diverticulitis in Korea.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"428-463"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteration of miR-21 and miR-24 expression: biomarker for early detection of synchronous metastases in colorectal cancer: a cross-sectional study in Indonesia.","authors":"Yudith Annisa Ayu Rezkitha, Amal Arifi Hidayat, Irine Normalina, Ricky Indra Alfaray, Maria Inge Lusida, Takashi Matsumoto, Yoshio Yamaoka, Muhammad Miftahussurur","doi":"10.5217/ir.2024.00206","DOIUrl":"10.5217/ir.2024.00206","url":null,"abstract":"<p><strong>Background/aims: </strong>Timely detection with highly accurate biomarkers would be helpful in effectively managing colorectal cancer (CRC). We aim to investigate the accuracy of 3 emerging biomarkers-miR-21, miR-24, and miR-145-in detecting synchronous metastases in CRC.</p><p><strong>Methods: </strong>We recruited newly diagnosed CRC patients with extensive investigations to determine cancer staging and metastatic status. The expression levels of miR-21, miR-24, and miR-145 in tumor biopsy were measured using reverse transcription quantitative polymerase chain reaction. Multivariate and receiver operating characteristic analyses were conducted to evaluate the association and performance of these miRNAs in identifying various metastases.</p><p><strong>Results: </strong>Out of the 63 Indonesian patients involved, 37 (58.7%) were diagnosed with localized CRC, whereas the remaining 26 (41.3%) were identified as having metastases: 31.7% liver, 14.3% lung, 3.2% bone, and 4.8% other metastases. There was a significant downregulation of miR-24 expression in metastatic CRC patients compared to those without metastases (0.024 [4.680] vs. 12.900 [42.376], P< 0.01). Overexpression of miR-21 was identified as an independent risk factor of synchronous metastasis (odds ratio [OR], 1.016; 95% confidence interval [CI], 1.003-1.030; P< 0.05), particularly lung (OR, 1.011; 95% CI, 1.002-1.020; P< 0.05) and bone (OR, 1.022; 95% CI, 1.001-1.043; P< 0.05) metastases. No association was found between miR-145 expression and metastatic status. The miR-21/24 ratio accurately identified synchronous metastases irrespective of organ site, with an area under the curve (95% CI) of 0.833 (0.722-0.944) and positive predictive value of 94.4%.</p><p><strong>Conclusions: </strong>Alteration of miR-21 and miR-24 expression levels was associated with a high incidence of synchronous metastases in Indonesian CRC. The miR-21/24 ratio demonstrated significant potential as a biomarker for detecting synchronous metastases in CRC.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"595-604"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of surgical trends in Crohn's disease during the biologic era: population-based cohort insights from Taiwan, a low-endemicity region.","authors":"Er-Hsiang Yang, Nai-Yu Chen, Ching-Lan Cheng, Yu-Ching Chang, Po-Chuan Chen, Lu-Hsuan Wu, Jui-Wen Kang, Hsueh-Chien Chiang, Po-Jun Chen, Bo-Wen Lin, Hsin-Yu Kuo, Chiao-Hsiung Chuang","doi":"10.5217/ir.2025.00003","DOIUrl":"10.5217/ir.2025.00003","url":null,"abstract":"<p><strong>Background/aims: </strong>Surgery remains a crucial treatment option for Crohn's disease (CD), even with the introduction of biological agents. This nationwide cohort study in Taiwan investigates surgery trends and the impacts of biologics in a region with a low prevalence of CD.</p><p><strong>Methods: </strong>This retrospective population-based cohort study used Taiwan's National Health Insurance Database from 2003 to 2018. The cohort included 725 CD patients. Patient characteristics, surgery outcomes, and impact of the biologic era on surgical risk were analyzed.</p><p><strong>Results: </strong>During the study period, 292 CD patients (40.3%) underwent surgery, with 125 in the pre-biologic era and 167 in the post-biologic era. The incidences of intestinal surgery (IS) and perianal surgery (PS) have significantly decreased. The cumulative probabilities of IS were 20%, 35%, and 44% after 1, 5, and 10 years, respectively; the PS incidences were 3%, 5%, and 7%, respectively. The cumulative incidence of IS was significantly lower in the post-biologic era compared to the pre-biologic era (P= 0.049). CD patients had high second IS incidences of 31% at 5 years after the first IS.</p><p><strong>Conclusions: </strong>Our study demonstrates the surgical incidences have decreased in the biologic era but remained relatively high in a region with low disease prevalence. This suggests the need for further improvements in CD management.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"542-551"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of gut microbiota in super donors for fecal microbiota transplantation and isolated gut commensal bacteria of inhibition against Clostridioides difficile.","authors":"Ki Sung Kang, Gee Hyeun Choi, Yu Jin Kim, Won Suk Lee, Do Eun Lee, Min Yeong Kim, Hyuk Yoon, Dong Ho Lee","doi":"10.5217/ir.2025.00179","DOIUrl":"10.5217/ir.2025.00179","url":null,"abstract":"<p><strong>Background/aims: </strong>Fecal microbiota transplantation (FMT) is increasingly recognized as an alternative to antibiotics for treating recurrent Clostridioides difficile infection. The success of FMT heavily depends on the appropriate selection of donors, encompassing factors such as diet patterns, lifestyle, environmental exposures, and intestinal microbiota diversity.</p><p><strong>Methods: </strong>A potential super donor was identified from 5 healthy adults and provided stool samples periodically over 2 years (2021-2022). The samples underwent 16S rRNA sequencing via the Illumina MiSeq platform, and microbial diversity was analyzed using QIIME 2 in comparison with 152 healthy individuals.</p><p><strong>Results: </strong>The stool microbiome composition of the potential super donor remained stable without significant changes over a 2-year period. Both alpha and beta diversity analyses revealed significant differences between the super donor and the 152 healthy individuals. The super donor exhibited significantly higher microbial diversity based on alpha diversity metrics (P< 0.0001) and distinct compositional profiles as shown by beta diversity. Linear discriminant analysis effect size (LEfSe) analysis indicated that Faecalibacterium and Prevotella strains comprised a significant proportion, with notable differences in relative abundance patterns (P< 0.05). Furthermore, 7 bacterial species were isolated from the super donor, all of which demonstrated inhibitory effects on the growth of C. difficile in vitro.</p><p><strong>Conclusions: </strong>These findings suggest that selecting donors with specific microbiota profiles, particularly those exhibiting higher microbial diversity, may potentially contribute to the inhibition of C. difficile, and further clinical studies are warranted to validate these findings.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"583-594"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating perspectives on transabdominal intestinal ultrasound in inflammatory bowel disease management: a nationwide cross-sectional survey of physicians and patients in China.","authors":"Longxi Yun, Zhaojue Wang, Yujun Chen, Ning Chen, Yan Chen, Xiaoqi Zhang, Xiaoyan Xie, Ren Mao, Yue Li, Qingli Zhu, Minhu Chen","doi":"10.5217/ir.2025.00074","DOIUrl":"10.5217/ir.2025.00074","url":null,"abstract":"<p><strong>Background/aims: </strong>The awareness, accessibility, and utilization of transabdominal intestinal ultrasound (IUS) in inflammatory bowel disease (IBD) management from both physicians' and patients' perspectives remains unclear in China. This nationwide cross-sectional survey aimed to gauge the current utilization of IUS, physician and patient perceptions and knowledge gap in IBD management across China.</p><p><strong>Methods: </strong>A structured questionnaire, developed by the China IUS Group, was distributed to 612 physicians (69.8% of gastroenterologists, 28.0% of radiologists) from 38 tertiary hospitals and 1,154 IBD patients.</p><p><strong>Results: </strong>A total of 91.7% of physicians expressed an intention to incorporate IUS into future clinical practice. However, while 69.3% of physicians reported IUS availability at their institutions, its utilization varied widely. Only 16.5% of physicians applied IUS to more than 75% of their IBD patients. Additionally, 27.1% of physicians reported receiving IUS training. Radiologists were more likely than gastroenterologists to consider IUS as a sensitive tool for evaluating treatment efficacy (48.3% vs. 19.4%, P< 0.001), intestinal wall fibrosis (33.7% vs. 27.4%, P< 0.001), intestinal fistula (27.9% vs. 11.2%, P< 0.001), abdominal abscesses (49.4% vs. 28.6%, P< 0.001), and disease severity (30.2% vs. 11.0%, P< 0.001). Patients expressed high satisfaction with IUS (76.1%), yet 39.2% had safety concerns.</p><p><strong>Conclusions: </strong>Despite growing recognition of IUS in China, its wide utilization in IBD management requires further promotion. The notable disparity between gastroenterologists and radiologists regarding IUS underscores the need for targeted, specialty-specific training. Strengthening patient education efforts is essential to further enhance patient acceptance of IUS.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"504-519"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Week 2 remission with vedolizumab as a predictor of long-term remission in patients with ulcerative colitis: a multicenter, retrospective, observational study\".","authors":"Philippe Pinton","doi":"10.5217/ir.2025.00234","DOIUrl":"10.5217/ir.2025.00234","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"605-606"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey on the practices and patterns in the management of acute severe ulcerative colitis in India.","authors":"Arshia Bhardwaj, Arshdeep Singh, Riya Sharma, Vandana Midha, Ajit Sood","doi":"10.5217/ir.2025.00060","DOIUrl":"10.5217/ir.2025.00060","url":null,"abstract":"<p><strong>Background/aims: </strong>The real-world management of acute severe ulcerative colitis (ASUC) varies considerably across regions and healthcare settings. This study aimed to evaluate current management practices for ASUC among gastroenterologists in India.</p><p><strong>Methods: </strong>A structured, web-based survey covering 5 thematic domains (provider and institutional characteristics, clinical workload and initial management, diagnostic practices, infectious work-up, and strategies for rescue therapy) was disseminated via email. Responses were analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 228 responses were received from across India's 5 geographic zones. The majority of respondents were affiliated with either corporate hospitals (n = 76, 33.3%) or teaching hospitals (n = 68, 29.8%). The majority (n = 135, 59.2%) reported managing up to 10 ASUC cases annually. The Truelove and Witts criteria were the most commonly used for diagnosis (n = 169, 74.1%). Nutritional assessment was performed by 89 respondents (39.0%). Biopsies for cytomegalovirus during index sigmoidoscopy were obtained by 75 (32.9%). Intravenous hydrocortisone was the preferred steroid (n = 188, 82.5%). Low molecular weight heparin for thromboprophylaxis was never prescribed by 62 respondents (27.2%). Oxford criteria were most frequently used to assess steroid response (n = 150, 65.8%). More than half of the respondents (n = 125, 54.8%) reported that fewer than 50% of patients accepted rescue therapy. Rescue therapy was initiated on or after day 5 by 153 respondents (67.1%). Early involvement of colorectal surgeons was reported by 66 (28.9%). A majority (n = 200, 87.7%) were associated with low-volume centers for ileal pouch-anal anastomosis, performing < 5 procedures per year.</p><p><strong>Conclusions: </strong>This nationwide survey reveals considerable heterogeneity in ASUC management in India. Standardizing care through patient and healthcare provider education and context-specific guidelines is imperative.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"520-531"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orofacial granulomatosis in pediatric Crohn's disease: clinical outcomes and genetic background in the era of biologics: a retrospective study in Japan.","authors":"Ryusuke Nambu, Takeo Naito, Mei Haruyama, Junichi Hosokawa, Hirotaka Shimizu, Ichiro Takeuchi, Shin-Ichiro Hagiwara, Tatsuki Mizuochi, Yugo Takaki, Takashi Ishige, Takuya Nishizawa, Takahiro Kudo, Natsuki Ito, Yosuke Kawai, Yoichi Kakuta, Masao Nagasaki, Toshiaki Shimizu, Itaru Iwama, Katsuhiro Arai","doi":"10.5217/ir.2025.00109","DOIUrl":"10.5217/ir.2025.00109","url":null,"abstract":"<p><strong>Background/aims: </strong>Occasionally, pediatric Crohn's disease (CD) may develop after diagnosis of orofacial granulomatosis (OFG), which is characterized by chronic granulomatous lesions of the oral mucosa, lips, and perioral area. This study aimed to clarify clinical characteristics, treatment responses, and potential genetic contributors in pediatric patients with CD complicating OFG.</p><p><strong>Methods: </strong>We studied pediatric patients with CD complicating OFG who were treated from 2013 to 2022 at 7 Japanese institutions specializing in pediatric inflammatory bowel disease. Their clinical courses were analyzed retrospectively, and analyses of 71 genes associated with monogenic inflammatory bowel disease were performed.</p><p><strong>Results: </strong>Among 13 patients, 8 were girls. Median ages at diagnosis of OFG and CD were 9.2 (3.8-15.3) and 10.3 (6.4-15.3) years old, respectively. Upper gastrointestinal lesions were frequent in 8 cases (62%), while perianal lesions were present in 7 (54%). OFG failed to improve or relapsed despite remission of intestinal lesions in about half of the patients (n = 7, 54%). During follow-up, OFG went into remission in 7 patients, including 6 of the 9 who were treated with biologics (66%) and 1 of the 4 who were not (25%). In 8 patients, the NCF1 p.Arg90His allele was detected by genetic analysis; 7 were heterozygous and 1 homozygous, a higher prevalence than in the general Japanese population.</p><p><strong>Conclusions: </strong>Clinical features of OFG associated with pediatric CD are diverse, and biologic agents were beneficial for OFG patients. NCF1 p.Arg90His mutation may contribute to the pathogenesis of pediatric CD complicating OFG.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"571-582"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of adjunctive use of antibiotics in acute severe ulcerative colitis: a propensity score matching analysis.","authors":"Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Nak-Hoon Son, Jae Hee Cheon","doi":"10.5217/ir.2025.00341","DOIUrl":"https://doi.org/10.5217/ir.2025.00341","url":null,"abstract":"<p><strong>Background/aims: </strong>The exact cause of ulcerative colitis (UC) remains unclear but likely involves an immune response to an unidentified component of gut microbiota. The use of antibiotics in treating acute severe UC (ASUC) remains controversial. This study aimed to assess the benefits of adding antibiotics to corticosteroids for managing ASUC.</p><p><strong>Methods: </strong>This retrospective study included patients with ASUC who met the Truelove and Witts diagnostic criteria at admission and received intravenous (IV) corticosteroids, with or without adjunctive antibiotics. Key outcomes included the need for medical and surgical rescue therapy during hospitalization and UC-related re-hospitalization rates at 1 week, 3 months, and 1 year. Propensity score matching (PSM) was employed to minimize selection bias in evaluating the impact of adjunctive antibiotics on clinical outcomes.</p><p><strong>Results: </strong>Of the 386 screened patients, 222 met the inclusion criteria: 75 (33.8%) received IV corticosteroids alone, while 147 (66.2%) received IV corticosteroids combined with antibiotics. After PSM (60 patients per group), the addition of antibiotics showed no significant effect on the need for medical rescue therapy during hospitalization, re-hospitalization, or clinical response based on the partial Mayo score after 1 week of hospitalization (68.3% vs. 60.0%; P= 0.341). Similarly, no significant differences were observed in the need for medical rescue therapy, re-hospitalization, or UC-related surgery rates at 3 months or 1 year (P> 0.05).</p><p><strong>Conclusions: </strong>In patients with ASUC, treatment outcomes did not significantly differ between those receiving IV corticosteroids alone and those receiving a combination of IV corticosteroids and antibiotics, suggesting that adjunctive antibiotic use may offer no added clinical benefits.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between anti-tumor necrosis factor alpha exposure and new-onset autoimmune diseases in inflammatory bowel disease: a nationwide case-control study in Korea.","authors":"Shin Ju Oh, Ji Eun Kim, Su Jin Jeong, Chang Kyun Lee","doi":"10.5217/ir.2025.00195","DOIUrl":"10.5217/ir.2025.00195","url":null,"abstract":"<p><strong>Background/aims: </strong>Autoimmune-related events following anti-tumor necrosis factor alpha (anti-TNF-α) therapy are increasingly reported, but population-level data on new-onset autoimmune disease in inflammatory bowel disease (IBD) remain limited. We evaluated whether anti-TNF-α exposure is associated with autoimmune disease development in IBD.</p><p><strong>Methods: </strong>We conducted a nationwide population-based case-control study using data from the Korean National Health Insurance Service database (2004-2018). Patients with IBD who developed new-onset autoimmune diseases, including psoriasis, interstitial lung disease (ILD), systemic lupus erythematosus, systemic vasculitis, and central nervous system disorders, were matched 1:1 to controls by age, sex, diagnosis year, and IBD subtype. Logistic regression with propensity score matching and spline modeling was used to assess associations, including subgroup and sensitivity analyses.</p><p><strong>Results: </strong>Among 8,586 matched pairs, anti-TNF-α therapy was associated with increased risks of autoimmune disease (adjusted odds ratio [aOR], 1.65), particularly psoriasis (aOR, 1.58) and ILD (aOR, 1.88). A non-linear dose-response relationship was observed: the risk rose sharply at early exposure, plateaued at approximately 30 prescriptions, and gradually declined beyond 64. This association remained regardless of prior immunosuppressant use and was attenuated but significant in immunosuppressant users with psoriasis. No significant associations were found for systemic lupus erythematosus, central nervous system disorders, or vasculitis. Patients receiving prolonged concomitant therapy ( ≥ 90 days) showed increased risk (aOR, 1.43). Monotherapy showed a non-significant trend (aOR, 1.19).</p><p><strong>Conclusions: </strong>Anti-TNF therapy for IBD is associated with an increased risk of developing new-onset autoimmune diseases, especially psoriasis and ILD. Careful monitoring is warranted, particularly in patients receiving prolonged or combined immunosuppressive therapies.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"464-474"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}