Therapeutic Advances in Gastroenterology最新文献

{"title":"Tryptophan metabolites profile predict remission with dietary therapy in pediatric Crohn's disease.","authors":"Rotem Sigall Boneh, Nikki van der Kruk, Eytan Wine, Charlotte M Verburgt, Tim G J de Meij, Mark Löwenberg, Krisztina B Gecse, Nicolette Wierdsma, Joep P M Derikx, Wouter J de Jonge, Geert D'Haens, Mohammed Ghiboub, Johan E Van Limbergen","doi":"10.1177/17562848251323004","DOIUrl":"10.1177/17562848251323004","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) exclusion diet combined with partial enteral nutrition (CDED + PEN) or exclusive enteral nutrition (EEN) is effective in inducing remission in mild-to-moderate pediatric CD. Although CDED + PEN is better tolerated and has higher compliance compared to EEN, a subset of patients does not achieve remission. Diet-induced remission is shown to be positively associated with specific changes in tryptophan-metabolites.</p><p><strong>Objectives: </strong>To investigate whether the abundance of baseline fecal tryptophan-metabolites predicts dietary therapy outcomes in pediatric CD.</p><p><strong>Design: </strong>Diagnostic accuracy study and secondary analysis of previously conducted Randomized Controlled Trial (RCT).</p><p><strong>Methods: </strong>Twenty-six patients from previously performed RCT of mild-to-moderate pediatric CD were included. The patients were classified as having clinical remission (R) (<i>n</i> = 19 in total; CDED + PEN = 10 and to EEN = 9) or No-Remission (NR) (<i>n</i> = 7 in total; CDED + PEN = 3 and EEN = 4) following 6 weeks of therapy, based on the Pediatric Crohn's Disease Activity Index score (⩽10 = remission). We performed a targeted quantitative analysis of 21 tryptophan-metabolites in baseline (<i>t</i> = 0) fecal samples from both groups, utilizing liquid chromatography coupled with quadrupole mass spectrometry. Receiver operator characteristic curve (ROC) and random forest analysis (RFA) were used to assess the predictive power of fecal tryptophan-metabolites for dietary outcomes at baseline. Ratios of tryptophan-metabolites were compared to investigate different downstream tryptophan pathways.</p><p><strong>Results: </strong>Baseline fecal kynurenine level was significantly higher in NR compared to R for CDED + PEN (<i>p</i> = 0.02) and EEN (<i>p</i> = 0.04). ROC analysis highlighted the robust predictive power of kynurenine for CDED + PEN (area under the curve (AUC = 0.97)) and EEN (AUC = 0.88)-induced remission. RFA corroborated these observations. The ratio serotonin/kynurenine was the strongest predictor of CDED + PEN-induced remission (AUC = 1). The ratio 5-hydroxytryptophan/kynurenine (AUC = 0.88) predicted EEN-induced remission. By combining data from CDED + PEN and EEN, kynurenine (AUC = 0.91) and ratios of quinolinic acid/kynurenine (AUC = 0.93) and kynurenine/indole-3-acetic acid (AUC = 0.88) demonstrated strong predictive performance for dietary therapy-induced remission.</p><p><strong>Conclusion: </strong>Baseline tryptophan metabolites have the potential to serve as a biomarker for dietary remission in pediatric CD. Some tryptophan metabolite ratios showed the most promising predictive capabilities. If confirmed in validation studies, baseline fecal tryptophan markers may be able to provide much-needed guidance to personalize dietary intervention within the management of pediatric CD.</p><p><strong>Trial registration: </strong>NCT01728870.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251323004"},"PeriodicalIF":3.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517125","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":"Body mass index changes after fecal microbiota transplantation for recurrent <i>Clostridioides difficile</i> infection.","authors":"Kanika Sehgal, Parul Berry, Janice Cho, George Saffouri, Ross A Dierkhising, Eric Battaglioli, Purna C Kashyap, Darrell Pardi, Sahil Khanna","doi":"10.1177/17562848251321121","DOIUrl":"10.1177/17562848251321121","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota transplantation (FMT) is a successful therapy for <i>Clostridioides difficile</i> infection (CDI). FMT from overweight donors is speculated to influence the recipient's body mass index (BMI) after administration for CDI.</p><p><strong>Objectives: </strong>We investigated changes in the recipient's BMI after FMT in relation to the donor's BMI.</p><p><strong>Design: </strong>We conducted a retrospective cohort study involving patients who underwent FMT for recurrent CDI at Mayo Clinic between 2012 and 2019.</p><p><strong>Methods: </strong>We analyzed demographic and donor data for patients undergoing FMT at Mayo Clinic (2012-2019). Recipient BMI (pre- and post-FMT) and donor BMI were extracted from medical records. Mixed-effects linear regression was used to evaluate the impact of donor BMI, donor BMI category, recipient baseline BMI, time before and after FMT, and interactions between these variables on overall BMI change and BMI change per month. Kaplan-Meier curves were used to assess BMI changes (⩾5 units) based on the last recorded post-FMT BMI.</p><p><strong>Results: </strong>We analyzed data from 401 patients with recorded BMI measurements before and after FMT. The median age of the recipients at the time of FMT was 59.1 years (interquartile range (IQR): 40.5-70.1 years), with 61.6% being female. The median BMI for recipients prior to FMT was 26.7 kg/m² (IQR: 22.7-31.6 kg/m²), while the median BMI of the donors was 24.5 kg/m² (IQR: 23.9-27.5 kg/m²). Stool from donors with a normal BMI was used for 58.2% of recipients, while 41.8% received stool from pre-obese donors. Donor BMI data were missing for 3.2% of recipients. Donor BMI was not significantly associated with changes in recipient BMI; for each 1-unit increase in donor BMI, a 0.01-unit monthly increase was observed (95% confidence interval: -0.0003, 0.02; <i>p</i> = 0.11). The log-rank test for BMI increases (⩾+5) and decreases (⩽-5) revealed no significant differences among the donor BMI groups (Chi-squared = 4.4, <i>p</i> = 0.1 for increases, Chi-squared = 2, <i>p</i> = 0.4 for decreases).</p><p><strong>Conclusion: </strong>The lack of impact of donor BMI on BMI changes post-FMT suggests that these changes are more dependent on the recipient's metabolic profile. Prospective, controlled trials are required to analyze these results more comprehensively.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251321121"},"PeriodicalIF":3.9,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494429","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":"Artificial intelligence to revolutionize IBD clinical trials: a comprehensive review.","authors":"Rocio Sedano, Virginia Solitano, Sudheer K Vuyyuru, Yuhong Yuan, Jurij Hanžel, Christopher Ma, Olga Maria Nardone, Vipul Jairath","doi":"10.1177/17562848251321915","DOIUrl":"10.1177/17562848251321915","url":null,"abstract":"<p><p>Integrating artificial intelligence (AI) into clinical trials for inflammatory bowel disease (IBD) has potential to be transformative to the field. This article explores how AI-driven technologies, including machine learning (ML), natural language processing, and predictive analytics, have the potential to enhance important aspects of IBD trials-from patient recruitment and trial design to data analysis and personalized treatment strategies. As AI advances, it has potential to improve long-standing challenges in trial efficiency, accuracy, and personalization with the goal of accelerating the discovery of novel therapies and improve outcomes for people living with IBD. AI can streamline multiple trial phases, from target identification and patient recruitment to data analysis and monitoring. By integrating multi-omics data, electronic health records, and imaging repositories, AI can uncover molecular targets and personalize trial strategies, ultimately expediting drug development. However, the adoption of AI in IBD clinical trials encounters significant challenges. These include technical barriers in data integration, ethical concerns regarding patient privacy, and regulatory issues related to AI validation standards. Additionally, AI models risk producing biased outcomes if training datasets lack diversity, potentially impacting underrepresented populations in clinical trials. Addressing these limitations requires standardized data formats, interdisciplinary collaboration, and robust ethical frameworks to ensure inclusivity and accuracy. Continued partnerships among clinicians, researchers, data scientists, and regulators will be essential to establish transparent, patient-centered AI frameworks. By overcoming these obstacles, AI has the potential to enhance the efficiency, equity, and efficacy of IBD clinical trials, ultimately benefiting patient care.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251321915"},"PeriodicalIF":3.9,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494426","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":"Itopride in functional dyspepsia: open-label, 1-year treatment follow-up of two multicenter, randomized, double-blind, placebo-controlled trials.","authors":"Bert Broeders, Jan Tack, Nicholas J Talley","doi":"10.1177/17562848251321123","DOIUrl":"10.1177/17562848251321123","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is common but few efficacious therapies exist. Itopride, a prokinetic, acts via dopamine D2 receptor antagonism and acetylcholinesterase inhibition, and is now approved in Japan, Mexico, and Europe for FD. However, long-term efficacy and safety data have not been published.</p><p><strong>Objective: </strong>To evaluate the long-term safety and potential effectiveness of itopride.</p><p><strong>Design: </strong>A long-term open-label drug effectiveness study.</p><p><strong>Methods: </strong>Males and females, 18-65 years, with FD (Rome II) and the absence (by upper endoscopy) of any relevant structural disease were recruited. After the double-blind treatment phase, patients were treated in an open-label extension phase.</p><p><strong>Results: </strong>A total of 798 patients were included in these two open-label trials and received at least one dose of study medication; 551 patients (69.0%) completed 6 months of treatment, and 294 patients (36.8%) completed a 12-month period. Response rates based on the global physician assessment were 61.7%, 64.8%, 69.0 %, 69.1%, 70.1%, 73.1%, and 77.9% at weeks 8, 16, 24, 32, 40, 48, and 52, respectively. Compliance was above 95%. The safety and tolerability profiles were as expected, with the majority of adverse events being gastrointestinal. Prolactin elevations occurred in 3% of the cases but were not clinically significant. No ECG changes were identified.</p><p><strong>Conclusion: </strong>In this population, itopride, given for up to 12 months, was safe, and up to two-thirds appeared to maintain symptom benefit.</p><p><strong>Trial registration: </strong>NCT00110968 and NCT00112203.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251321123"},"PeriodicalIF":3.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484470","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":"The role of mastery in Crohn's disease: a cross-sectional study.","authors":"Marina Francesca Gattoni, Enrica Previtali, Salvatore Leone, Alessia Amore, Eleonora Volpato","doi":"10.1177/17562848251314796","DOIUrl":"10.1177/17562848251314796","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is a chronic autoimmune inflammatory bowel disease. It is estimated that approximately 40% of individuals with CD are non-adherent to medical prescriptions. This lack of adherence to treatment plans has been linked to an increased risk of hospitalisation and surgical procedures, which can have a detrimental impact on the patient's quality of life (QoL). Furthermore, the CD can impose significant stress on individuals, affecting their mental health and sense of mastery. The term 'mastery' is used to describe an individual's awareness of their abilities and capacities that are essential for effectively managing life events and situations.</p><p><strong>Objectives: </strong>This study aimed to investigate the role of mastery in relation to medical adherence, distress, perceived social support, QoL, depressive and anxious symptoms and interoception in persons with a diagnosis of CD.</p><p><strong>Design: </strong>This is a cross-sectional study, involving 261 adults diagnosed with CD.</p><p><strong>Methods: </strong>Participants completed an online questionnaire comprising validated clinical and psychological scales, which lasted approximately 20 min. Participants were permitted to provide their most recently available medical report.</p><p><strong>Results: </strong>Patients with CD reported discrete levels of mastery. Two factorial ANOVA highlighted statistically significative differences in mastery in relation to clinical conditions (<i>F</i>(2, 253) = 11.22, <i>p</i> < 0.001) and a significative interaction effect between gender and symptomatology (<i>F</i>(2, 253) = 7.22, <i>p</i> < 0.001). Multiple linear regression illustrated a statistically significant association between mastery, clinical conditions, QoL, stress and interoception (adjusted <i>R</i> square = 0.558; <i>F</i>(14, 211) = 21.32, <i>p</i> < 0.001). Concerning the possible mediator role of mastery between psychological state and medical adherence, no statistically significant results emerged from the mediation model analysis.</p><p><strong>Conclusion: </strong>This study highlighted an effective impairment of mastery in CD patients, especially among men experiencing mild disease activity. A positive association between mastery and enteroception was outlined. The higher prevalence of distress, anxiety and depressive symptoms connected to mastery was substantiated. Future research should deepen the relationship between mastery with medical adherence.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251314796"},"PeriodicalIF":3.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460319","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":"Risk factors and clinical characteristics of <i>Clostridium difficile</i> colonization and infection in patients with inflammatory bowel disease exposed to Vedolizumab: a multicenter retrospective study.","authors":"Qing Li, Xiaomei Song, Peizhu Su, Xiaoping Lv, Xinyu Liu, Xuemin Chen, Jian Tang, Xiang Gao, Kang Chao","doi":"10.1177/17562848251321707","DOIUrl":"10.1177/17562848251321707","url":null,"abstract":"<p><strong>Background: </strong>Vedolizumab (VDZ), a humanized monoclonal antibody that selectively inhibits the binding of the α4β7 integrin, has been approved for treating inflammatory bowel disease (IBD). Long-term safety studies of VDZ in clinical trials identified <i>Clostridium difficile</i> infection (CDI) as the major opportunistic infection.</p><p><strong>Objectives: </strong>We aimed to address the incidence and risk factors of <i>C. difficile</i> colonization (CDC) and CDI in a real-world setting among IBD patients treated with VDZ.</p><p><strong>Design: </strong>Retrospective multicenter study.</p><p><strong>Methods: </strong>We retrospectively included IBD patients who tested negative for <i>C. difficile</i> before initiating standard VDZ therapy at four tertiary hospitals from November 1, 2021, to November 31, 2023. The primary outcome was the occurrence of CDC after VDZ initiation, and the secondary outcome was the occurrence of CDI and severe CDI.</p><p><strong>Results: </strong>A total of 454 patients were included in the final analysis. The median follow-up time was 12.9 (8.2-16.3) months, and the study was followed for 2488.6 person-months. The CDC occurred in 28 patients (6.2%), including 23 (11.4%) patients with ulcerative colitis (UC; 18 asymptomatic carriers and 5 with symptomatic CDI) and 5 (2.0%) patients with Crohn's disease (asymptomatic carriers). Multivariate analysis showed that age >40 years old and UC were independent risk factors for the occurrence of the CDC after VDZ initiation. The incidence of CDI was 1.1%, and all patients were able to continue VDZ therapy after receiving antibiotic treatment. No risk factors were found to be significantly associated with CDI. There were no cases of severe CDI or deaths within 30 days.</p><p><strong>Conclusion: </strong>The incidence of CDC after VDZ treatment was 6.2% and the majority of patients identified as asymptomatic carriers and were able to continue VDZ treatment. Age (>40 years old) and UC were the risk factors for CDC.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251321707"},"PeriodicalIF":3.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460352","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":"Efficacy and safety of sequential cutting of nasobiliary tubes as an alternative to stent placement after nasobiliary drainage for the treatment of hilar malignant biliary stricture: a retrospective cohort study.","authors":"Wangyang Chen, Peiyao Huang, Xinyi Gu, Xiaodie Liu, Xiuzhiye Ying, Jianfeng Yang","doi":"10.1177/17562848251319809","DOIUrl":"10.1177/17562848251319809","url":null,"abstract":"<p><strong>Background: </strong>The rising incidence of hilar malignant bile duct strictures poses challenges for diagnosis and treatment. While endoscopic treatment is essential for relieving obstruction, it carries a high risk of postoperative cholangitis. Sequential cutting of nasobiliary tubes as an alternative to stent placement after nasobiliary drainage may emerge as an effective strategy to mitigate these complications.</p><p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of nasobiliary tube cutting after nasobiliary drainage versus conventional stent placement in reducing postoperative cholangitis in patients with hilar malignant biliary strictures.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>From 2015 to 2023, 208 patients were divided into two groups: nasobiliary tube cutting group (<i>n</i> = 103) and conventional stent group (<i>n</i> = 105). The primary outcome was postoperative cholangitis, with secondary outcomes including drainage success, bilirubin reduction, re-interventions, complications, and hospital stay.</p><p><strong>Results: </strong>Cholangitis occurred in 11.7% of the nasobiliary tube cutting group and 26.7% of the conventional stent group (<i>p</i> = 0.006). Successful drainage was achieved in 84 patients (81.6%) in the nasobiliary tube cutting group and 78 patients (74.3%) in the conventional stent group, with no statistically significant difference (<i>p</i> = 0.207). Patients whose total bilirubin reduction >50% within 7 days were significantly higher in the nasobiliary tube cutting group (48.5% vs 27.6%, <i>p</i> = 0.002). There were no significant differences between the groups in the number of endoscopic retrograde cholangiopancreatography procedures or re-interventions required (<i>p</i> > 0.05). Except for postoperative cholangitis, other postoperative complications were comparable between the groups (<i>p</i> > 0.05). The postoperative hospital stay was significantly longer in the nasobiliary tube cutting group, with a median duration of 10.0 (7.0, 14.0) days compared to 7.0 (5.5, 12.5) days in the conventional stent group (<i>p</i> = 0.024). Bismuth-Corlette Type IV was identified as an independent risk factor for cholangitis (OR = 3.207, 95%CI: 1.253-8.210, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>For patients with hilar malignant biliary stricture, sequential cutting of nasobiliary tubes as an alternative to stent placement after nasobiliary drainage may reduce the incidence of postoperative cholangitis and achieve early successful drainage, but it may result in a prolonged postoperative hospital stay. Bismuth-Corlette Type IV is an independent risk factor for the development of postoperative cholangitis.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251319809"},"PeriodicalIF":3.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442580","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":"Higher disease activity of inflammatory bowel disease predisposes to <i>Clostridioides difficile</i> infection.","authors":"Krista Vitikainen, Merit Kase, Leo Meriranta, Pauliina Molander, Clas-Göran Af Björkesten, Veli-Jukka Anttila, Perttu Arkkila","doi":"10.1177/17562848251318292","DOIUrl":"10.1177/17562848251318292","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) is a clinical challenge associated with poor outcomes in patients with inflammatory bowel disease (IBD).</p><p><strong>Objectives: </strong>To identify clinical risk factors for CDI and its recurrence among patients with IBD.</p><p><strong>Design: </strong>Case-control cohort study of IBD patients with and without episodes of CDI.</p><p><strong>Methods: </strong>A case-control study of 279 IBD patients with CDI. Medical history and IBD-related symptoms 3 months preceding a toxin-positive CDI were recorded and compared with age- and sex-matched IBD patients without CDI. Outcomes of CDI in IBD patients were recorded 2-6 months after CDI.</p><p><strong>Results: </strong>Based on clinical symptoms and fecal calprotectin levels, IBD is active before CDI. Recently diagnosed IBD seemed to increase the risk for CDI. Corticosteroid usage frequently preceded CDI episodes. Advanced therapies were not associated with CDI. Antibiotic intake was not registered before CDI in 30% of the episodes. Recurrent CDI (rCDI) occurred in 30% (84/279) of IBD-CDI patients and 67% (90/135) of those episodes were registered within 90 days from the preceding episode. Most (79%) rCDI patients had ulcerative colitis (UC). CDI could complicate underlying IBD by increasing the need for escalation in IBD-related medical therapy and leading to hospitalization but it did not seem to increase the risk of colectomy.</p><p><strong>Conclusion: </strong>The major risk factors associated with CDI in IBD patients were IBD activity before infection, UC and colonic Crohn's disease, short duration of IBD, corticosteroid usage, and hospitalization. Patients with active IBD and a shorter disease duration may benefit from more frequent follow-ups in the early stages, as they appear to be at higher risk of developing CDI.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251318292"},"PeriodicalIF":3.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442582","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":"RISE-MX, a real-world study of patients with moderate/severe inflammatory bowel disease returning for hospital follow-up in Mexico: baseline demographics and clinical characteristics, treatment and disease status.","authors":"Manuel Alejandro Martínez-Vázquez, Francisco J Bosques-Padilla, Rosa María Miranda-Cordero, Jesus K Yamamoto-Furusho","doi":"10.1177/17562848251318857","DOIUrl":"10.1177/17562848251318857","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is characterized by periods of remission and relapses, and treatment is based on phenotype, risk factors, and disease severity. Treatments include 5-aminosalicylates (5-ASA), thiopurines, methotrexate, calcineurin inhibitors, corticosteroids (CS), biological therapy (BxT), and, more recently, small molecules.</p><p><strong>Objective: </strong>To determine the baseline demographics and clinical characteristics, treatment patterns, and disease status of patients in Mexico with a history of moderate/severe IBD returning for hospital follow-up (Index Day).</p><p><strong>Design: </strong>This was a non-interventional, cross-sectional study.</p><p><strong>Methods: </strong>Socio-demographics, clinical characteristics, and prescribed treatments were collected from a retrospective review (3 years) of each patient's medical records.</p><p><strong>Results: </strong>A total of 326 patients with a diagnosis of moderate/severe IBD at least 6 months before the Index Day were included in the analysis: 95 patients (29.2%) had Crohn's disease (CD) and 231 (70.9%) ulcerative colitis (UC). In the CD group, 45.3% (<i>n</i> = 43) had a Harvey Bradshaw Index score ⩾8 or Crohn's Disease Activity Index ⩾220; 10 patients had a B1-non-stenosing, non-penetrating phenotype and 17 had stenosis (B2). In the UC group, 18.2% (<i>n</i> = 42) had moderate/severe disease and the most frequent presentation was pancolitis (<i>n</i> = 56). Regarding treatment over the previous 3 years: for CD, 62 (65.3%) received CS and 20.0% (<i>n</i> = 19) were CS-dependent; 30.5% received 5-ASA + IMS; 27.4% BxT + IMS; and 38.9% 5-ASA + IMS + BxT. In the case of UC, 74.9% (<i>n</i> = 173) received CS and 32.9% (<i>n</i> = 76) were CS-dependent; 64.5% received 5-ASA + IMS; 2.2% BxT + IMS; and 31.6% 5-ASA + IMS + BxT.</p><p><strong>Conclusion: </strong>In Mexico, 45.3% of CD patients and 18.1% with UC presented with moderate/severe disease activity. Conventional therapy was used to treat the majority of patients, and the availability of more advanced therapies and a personalized treatment approach is needed to improve clinical outcomes in the future.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251318857"},"PeriodicalIF":3.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450744","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":"Histone deacetylase in inflammatory bowel disease: novel insights.","authors":"Chunxiao Li, Shaobo Gu, Yihong Zhang, Zhenruo Zhang, Junzhuo Wang, Ting Gao, Kangpeng Zhong, Keshu Shan, Guoliang Ye, Yini Ke, Yi Chen","doi":"10.1177/17562848251318833","DOIUrl":"10.1177/17562848251318833","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is characterized by chronic nonspecific intestinal inflammation. Despite considerable efforts, IBD remains a heavy burden on society and human health, with increasing morbidity. Posttranslational modification, especially histone acetylation, is a key process in controlling DNA transcriptional activity. Histone deacetylases (HDACs) play a vital role in the mechanism of IBD pathogenesis through histone and nonhistone protein deacetylation. Herein, we present a summary of different categories of HDACs as well as HDAC inhibitors (HDACis) and analyze the role of HDAC inhibition in alleviating IBD along with its mechanism, as well as clinical potential of HDACis in IBD treatment.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251318833"},"PeriodicalIF":3.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442583","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}