Journal of Crohn's & colitis最新文献

{"title":"Unravelling the genetic architecture of inflammatory bowel disease multiplex families with rare and common variant polygenic risk scores.","authors":"Deborah Sarah Jans, Jana Depovere, Ho-Su Lee, Yasmina Abakkouy, Sara Becelaere, Margaux David, Maaike Vancamelbeke, Justien Degry, Marc Ferrante, João Sabino, Séverine Vermeire, Isabelle Cleynen","doi":"10.1093/ecco-jcc/jjaf165","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf165","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) often affects multiple relatives, pointing towards shared genetic and/or environmental factors. This study evaluates the importance of known IBD risk variants, and of genetic determinants of smoking in such multiplex families.</p><p><strong>Methods: </strong>We studied 65 IBD multiplex families, comprising 146 Crohn's disease [CD], 33 ulcerative colitis [UC], and 111 unaffected relatives. All families had at least three affected first-degree relatives. Common variant and rare variant polygenic risk scores (PRS and rvPRS) in these individuals were calculated and compared to 2,040 sporadic IBD cases (1,198 CD, 842 UC) and 598 unrelated controls. Associations for PRS, rvPRS and smoking PRS were assessed using univariable and multivariable models.</p><p><strong>Results: </strong>Within multiplex families, unaffected relatives had lower PRS than affected relatives (p = 0.01), but still higher scores than unrelated controls (p = 0.01). Interestingly, rvPRS did not differ between affected and unaffected relatives. PRS and rvPRS showed substantial heterogeneity across families; e.g. 10 families (2 for rvPRS) had PRS below unrelated controls, while 27 (6 for rvPRS) scored above sporadic cases. No correlation was found between PRS and rvPRS at the individual or family level. Smoking-related PRS were not associated with familial IBD.</p><p><strong>Conclusion: </strong>Multiplex IBD families show diverse genetic architecture, with almost half showing a high burden of common and/or rare risk variants. While genetic predispositions to smoking influences IBD risk in sporadic cases, it provides limited insights into familial IBD. These findings highlight the genetic complexity within multiplex families and the need for tailored research approaches such as risk stratification and genetic screening strategies.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002200","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":"Combination therapy with biologics and/or small molecules in inflammatory bowel disease: a comprehensive review.","authors":"Javier P Gisbert, María Chaparro","doi":"10.1093/ecco-jcc/jjaf161","DOIUrl":"10.1093/ecco-jcc/jjaf161","url":null,"abstract":"<p><p>Advanced combination treatment (ACT)-the combination of two advanced agents such as biologics or small molecules-has emerged as a promising strategy in the management of inflammatory bowel disease refractory to conventional treatment, with severe extraintestinal manifestations, or with coexisting immune-mediated inflammatory diseases. ACT including complementary mechanisms of action aims to overcome the therapeutic ceiling observed with monotherapy. Its rationale is supported by preclinical and mechanistic data demonstrating synergistic immunological effects when distinct inflammatory pathways are targeted simultaneously. Although observational studies report pooled clinical and endoscopic remission rates of approximately 60% and 30%, respectively, the quality of evidence remains very limited. Most studies are retrospective, heterogeneous in patient populations and treatment regimens, and often report outcomes in aggregate, precluding firm conclusions regarding the efficacy of specific drug combinations. The two and only randomised controlled trials available to date have shown acceptable safety profiles but limited or no clear superiority of ACT over monotherapy. Safety data are reassuring, with no significant increase in serious adverse events. The optimal duration of ACT remains uncertain; while de-escalation to monotherapy following deep remission is feasible in selected patients, relapse rates vary, emphasizing the need for individualized treatment decisions and long-term follow-up. High treatment costs also pose a barrier to widespread adoption of ACT, though biosimilars may help offset these concerns. In summary, ACT may represent a potentially valuable therapeutic option in selected high-risk or treatment-resistant patients with inflammatory bowel disease; however, its true clinical benefit remains uncertain and requires confirmation through robust, well-powered randomised controlled trials.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983509","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":"Faecal loss of vedolizumab is associated with UC severity, lower serum vedolizumab levels and rates of clinical response: Results from the FAVOUR study.","authors":"Mark A Samaan, Georgina Cunningham, Samuel Hsiang Lim, Patrick Dawson, Sherine Hermangild Kottoor, Zareen Bheekhun, Emma Lee, Simon H Anderson, Joel Mawdsley, Shuvra Ray, Nick Powell, Krystal Rawstron, Robin Dart, Arkir Zehra, Peter M Irving","doi":"10.1093/ecco-jcc/jjaf159","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf159","url":null,"abstract":"<p><strong>Background and aims: </strong>We conducted a prospective study (FAVOUR) of patients with UC commencing vedolizumab to investigate faecal vedolizumab loss and its impact on serum levels and treatment outcomes.</p><p><strong>Methods: </strong>FAVOUR recruited patients with moderate-to-severe UC commencing vedolizumab. Faecal vedolizumab levels (FVL) were measured at days 1, 4, 7 and at weeks 2, 6 and 14. Trough serum vedolizumab levels (SVL) were measured at weeks 2, 6 and 14.</p><p><strong>Results: </strong>36 patients were recruited, of whom 33 completed induction therapy. Faecal vedolizumab was detectable in 80/203 (39%) samples. Statistically significant, positive correlations were observed between FVL and clinical, biochemical, baseline endoscopic and histologic disease activity at day 1, 4 and 7 as well as weeks 2 and 6. Week 14 clinical non-responders had higher FVL than responders at that time point (median 1.0 vs 0.0ug/g, p = 0.004) but not at other timepoints. Area-under-the-curve analysis of FVL was used to quantify cumulative vedolizumab stool loss. This demonstrated significant differences between week 14 clinical responders and non-responders (44 ug/g/day, 95% CI: 0-128 vs 233 ug/g/day, 95% CI 0-1139, p < 0.0001), as well as between endoscopic responders and non-responders (48 ug/g/day, 95% CI 0-142 vs 179 ug/g/day, 95% CI 0-142, p = 0.0017), with non-responders having a higher rate of cumulative loss.</p><p><strong>Conclusions: </strong>Active UC results in faecal loss of vedolizumab. This correlates with lower SVL and decreased response to treatment. Faecal loss of vedolizumab may be a marker of disease activity and/or result in lower rates of drug exposure at a tissue level, negatively impacting response.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983434","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":"Modulating checkpoint molecules in inflammatory bowel diseases as a new therapeutic strategy: a narrative review.","authors":"Zlata Chkolnaia, Walter Reinisch, Mathieu Uzzan","doi":"10.1093/ecco-jcc/jjaf160","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf160","url":null,"abstract":"<p><p>Inflammatory bowel diseases (IBD) are complex, multifactorial disorders characterized by a dysregulated immune response. While recent years have seen the emergence of numerous advanced therapies targeting inflammatory cytokines and their associated signaling pathways, achieving high rates of sustained remission remains a significant challenge. Stimulatory and inhibitory immune checkpoints, which are induced upon T cell activation, play a critical role in fine-tuning the immune response. Immune checkpoint inhibitors (ICI), by restoring T cell activity, have revolutionized cancer treatment. Conversely, modulating checkpoint molecules offers a promising strategy to dampen the excessive immune response observed in immune-mediated inflammatory diseases (IMIDs) such as IBD. In this review, we provide a comprehensive overview of immune checkpoint molecules, explore the rationale for targeting them in IBD, and summarize current evidence from clinical trials investigating checkpoint modulation in IMIDs.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983708","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":"Submucosal hyper-echogenicity on intestinal ultrasound is associated with fat deposition and predicts treatment non-response in patients with ulcerative colitis.","authors":"Maarten J Pruijt, E Andra Neefjes-Borst, Floris A E De Voogd, Marilyne M Lange, Christoph Teichert, Reimer J Janssen, Geert R D'Haens, Krisztina B Gecse","doi":"10.1093/ecco-jcc/jjaf158","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf158","url":null,"abstract":"<p><strong>Background and aims: </strong>The submucosa is the most responsive bowel wall layer on intestinal ultrasound (IUS) when assessing treatment response in ulcerative colitis (UC). Submucosal thickening with hyper-echogenicity is observed. This study aimed to quantify echogenicity and understand transmural changes in UC.</p><p><strong>Methods: </strong>118 patients were studied in two cohorts. Cohort 1 included colectomy patients: 19 UC and 52 controls without inflammatory bowel disease. Cohort 2 included 47 UC patients in a prospective cohort starting anti-inflammatory treatment. In cohort 1, submucosal inflammation, and fat and collagen deposition were scored by two pathologists using a semi-quantitative scale (0-3). For UC patients in cohort 1, histopathology and IUS of the sigmoid were location matched. Relative submucosal echogenicity (RSE) was assessed, quantified in grayscale values. In cohort 2, baseline sigmoid RSE was compared between endoscopic responders (≥1 point decrease in endoscopic Mayo score after 8-26 weeks) and non-responders.</p><p><strong>Results: </strong>In all colectomized UC patients with preserved wall layer stratification (n = 12, 63%), submucosal fat (score ≥1) was present; in those with loss of stratification (n = 7, 37%), fat was absent (score = 0). RSE was higher when fat was present (95.5 [IQR 86.5-116.9] vs. 8.1 [IQR 5.8-23.0] grayscale values, p < 0.001), with no significant differences for inflammation and collagen. In Cohort 2, RSE was higher in non-responders (n = 17) compared to responders (137.1 ± 50.9 vs. 88.3 ± 49.6 grayscale values, p = 0.003). An RSE of > 108 grayscale values predicted non-response (odds ratio: 0.07 [95% CI: 0.01-0.44], p = 0.004).</p><p><strong>Conclusion: </strong>Submucosal hyper-echogenicity on IUS indicates fat deposition and predicts non-response in UC.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983730","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":"Assessing intestinal fibrosis using an endoscopic photoacoustic-ultrasound balloon catheter in rabbits and a human subject.","authors":"Linyu Ni, Xiaorui Peng, Yaocai Huang, Yunhao Zhu, Laura A Johnson, Kathryn A Eaton, Jennifer Dixon, Xueding Wang, Peter Dr Higgins, Guan Xu","doi":"10.1093/ecco-jcc/jjaf155","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf155","url":null,"abstract":"<p><strong>Background and aims: </strong>Assessment of fibrosis in intestinal strictures in Crohn's disease could contribute to clinical decision making. Our recent studies demonstrate that endoscopic photoacoustic (PA) imaging can quantify the progression of intestinal fibrosis by its collagen content and its mechanical stiffness. The aim of this study is to evaluate the feasibility and diagnostic reliability of a PA-ultrasound balloon catheter in assessing intestinal fibrosis.</p><p><strong>Methods: </strong>Acute colonic colitis or chronic inflammation with fibrosis was induced in rabbits using intrarectal trinitrobenzene sulfonic acid. The affected distal colon was assessed through PA imaging in vivo and microelastometry ex vivo. Quantitative measurements were derived from the images and compared with histopathology. We also examined the feasibility of the catheter in a human subject with Crohn's disease strictures.</p><p><strong>Results: </strong>The quantitative PA imaging measurements in vivo detected an increased collagen/hemoglobin ratio of 1.42 arbitrary units (p < 0.001) in the chronic high fibrosis rabbit group compared to the acute colitis/low fibrosis and normal groups. The imaging results in vivo also showed an increased relative tissue stiffness of 4.27 KPa (p < 0.001) in the high fibrosis group compared to the low fibrosis and normal groups, which agrees with ex vivo microelastometer measurements. The human subject study demonstrates sufficient light penetration and signal-to-noise ratio for assessing intestinal fibrosis during a standard ileo-colonoscopy procedure.</p><p><strong>Conclusion: </strong>Our novel imaging catheter shows reliability in differentiating the changes in molecular components and mechanical properties during the progression of intestinal fibrosis. This catheter-based approach is fully compatible with clinical colonoscopy procedures.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984106","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":"Is 2nd JAKi treatment for UC worth the effort? A retrospective, multi-Centre UK study.","authors":"Chandni Radia, Yaa Danso, Susan Ritchie, Melissa Hale, Alexander T Elford, Chirag Patel, Lucy Hicks, Sonia Kalyanji, Chaonan Dong, Katie Yeung, Jie Han Yeo, Mohammed Allah-Ditta, Maria Bishara, Karishma Sethi-Arora, Lushen Pillay, Emma L Johnston, Ruth Rudling, Fiona Rees, Philip Harvey, Hannah Trodden-Mittnacht, Emma Davis, Aileen Fraser, Nitish Jivan Sawan, Muhammad Azhar Hussain, Roisin Campbell, Becky George, Megan Rawcliffe, Xin Yi Choon, Krishna Shah, Dania Al-Zarrad, Jennifer Toft, Puneet Chhabra, Nick Burr, Alice Hewitt, Rohith Kumar, Sara McCartney, Konstantina Rosiou, Anjan Dhar, Charlie W Lees, Christopher A Lamb, Ally Speight, Tariq Ahmad, Jimmy Limdi, Tim Raine, Alissa Walsh, Rachel Cooney, Paul Harrow, Kamal Patel, Mark Samaan, Polychronis Pavlidis, Alexandra Kent, Christian Selinger, Klaartje Kok","doi":"10.1093/ecco-jcc/jjaf154","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf154","url":null,"abstract":"<p><strong>Background and aims: </strong>Janus Kinase inhibitors (JAKi) provide effective treatment for ulcerative colitis (UC), but inadequate response (IR) or intolerance occurs frequently. This study aimed to assess effectiveness of a second JAKi in a real-world UC cohort.</p><p><strong>Methods: </strong>A retrospective multicentre cohort study encompassing 19 UK hospitals was undertaken. Primary outcome was clinical remission (Simple Clinical Colitis Activity Index/partial Mayo Score ≤ 1) at weeks 8 and 24, based on available assessments. Biochemical (CRP ≤ 5mg/L and faecal calprotectin ≤ 200µg/g) and endoscopic (Ulcerative Colitis Endoscopic Index of Severity/Mayo Endoscopic Subscore ≤ 1) remission were also assessed.</p><p><strong>Results: </strong>131 patients with active UC were included. Majority (60%) had exposure to ≥ 3 advanced therapies and 50% required corticosteroids at induction. Clinical remission rates were 59% and 51% at weeks 8 and 24. Biochemical and endoscopic remission rates were 61% and 60% at week 8 and 47% and 32% at week 24. All disease activity parameters significantly reduced by week 8 (p < 0.001). At week 24 no difference was detected in clinical remission rates between those with primary non-response (42%) or secondary loss of response (52%) to their first JAKi (p = 0.518). Clinical remission did not differ between upadacitinib (54%) and filgotinib (36%), p = 0.253. Adverse events occurred in 27% of patients, and serious adverse events in 8%.</p><p><strong>Conclusions: </strong>In this highly refractory cohort with active UC a second JAKi effectively achieved remission following IR to first JAKi. Type of first JAKi failure did not appear to influence clinical remission. No new safety signals were found.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983579","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":"Micronutrients are associated with endoscopic postoperative recurrence in Crohn's disease: a multicenter prospective cohort study in North america.","authors":"Michiel T J Bak, Karen Boland, Shadi Nayeri, Krzysztof Borowksi, Pablo A Olivera, Cristian Hernandez-Rocha, Williams Turpin, Joanne M Stempak, Steven R Brant, Judy H Cho, Richard H Duerr, Talin Haritunians, Mark G Lazarev, Emebet Mengesha, Dermot P B McGovern, John D Rioux, L Philip Schumm, Sun-Ho Lee, Mark S Silverberg","doi":"10.1093/ecco-jcc/jjaf148","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf148","url":null,"abstract":"<p><strong>Background and aims: </strong>Diet may influence the disease course in inflammatory bowel disease, but its role in postoperative outcomes for Crohn's disease (CD) remains unclear. This study aimed to assess the association of macro- and micronutrient intake with endoscopic postoperative recurrence (ePOR) in a prospective multicenter cohort.</p><p><strong>Methods: </strong>Patients with CD following ileocolic resection were prospectively recruited from six North American centers. Primary study outcome was ePOR (modified Rutgeerts' score ≥i2a) during follow-up. Nutritional intake was assessed through two-day food diaries verified by dietitian-delivered interview. Associations between nutrient intake and ePOR were evaluated. Random forest models with 10-fold cross-validation assessed the predictive value of nutrients and clinical factors for ePOR.</p><p><strong>Results: </strong>A total of 520 food diaries from 103 patients were analyzed; 37 patients (36%) experienced ePOR. Univariate analysis identified eight nutrients associated with ePOR including lower intake of isoflavones (genistein, daidzein, glycitein; p < 0.01), inositol (p < 0.01), pinitol (p = 0.02), provitamin-A carotenoid (p < 0.01), xylitol (p = 0.03) and parinaric Acid (p = 0.03). Sensitivity analysis confirmed the association of lower intake of all isoflavones (p < 0.01) and pinitol (p = 0.04) with ePOR at first postoperative colonoscopy. Random forest models showed poor discrimination for clinical factors alone (AUC 0.59) but an acceptable discrimination for nutrients alone (AUC 0.67), which improved when combining nutrients and clinical factors (AUC 0.71).</p><p><strong>Conclusion: </strong>Lower intake of specific micronutrients is associated with ePOR in CD patients. A machine-learning model combining nutrient intake and clinical factors enhanced the prediction of ePOR. These findings highlight the importance of postoperative nutritional assessment and suggest dietary interventions may help prevent postoperative recurrence in CD.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983594","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":"Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in medical management and precision medicine.","authors":"Uri Kopylov, Bram Verstockt, Urko M Marigorta, Daniele Noviello, Peter Bossuyt, Aart Mookhoek, Pieter Sinonque, Alaa El-Hussuna, Kapil Sahnan, Daniel C Baumgart, Nurulamin M Noor, Mariangela Allocca, Dan Carter, Arzu Ensari, Marietta Iacucci, Gianluca Pellino, Alessandra Soriano, Jan de Laffolie, Marco Daperno, Tim Raine, Isabelle Cleynen, Shaji Sebastian","doi":"10.1093/ecco-jcc/jjaf134","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf134","url":null,"abstract":"<p><strong>Background and aims: </strong>Artificial intelligence (AI) is increasingly being applied in various fields of medicine, including Inflammatory Bowel Diseases (IBD). This systematic review, conducted as part of the ECCO 9th Scientific Workshop on AI in IBD, explores AI applications in multiomic precision medicine, large language models (LLMs) for textual tasks and utilisation of wearable and remote care technologies.</p><p><strong>Methods: </strong>A comprehensive systematic analysis of the literature was undertaken, emphasising three topics: multiomic predictive models in IBD; natural language processing (NLP) and LLMs for clinical practice, research and patient communication; and the role of remote monitoring and wearable devices.</p><p><strong>Results: </strong>Key areas of promise include the implementation of NLP and LLMs for case identification and differentiation, tracking disease activity, pharmacovigilance, quality assurance and patient support. Multiomic approaches, integrating genomics, transcriptomics, proteomics, metabolomics and metagenomics, show potential for developing more accurate diagnostic and risk prediction models and improving treatment response prediction and detection of actionable drug targets for future therapeutics. Wearables and remote monitoring technologies can transform IBD management from episodic assessments to continuous less biased tracking of patient-reported outcomes and physiological biomarkers.</p><p><strong>Conclusions: </strong>While AI and multiomic approaches hold substantial promise for advancing IBD management and research, further refinement is necessary to ensure content validity and address safety concerns, thereby allowing integration of AI into clinical workflows and safeguarding of data privacy. Future research should prioritise the integration of diverse omic data, conduct of longitudinal studies and validation in large and diverse cohorts.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839477","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":"Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in Endoscopy, Radiology and Histology in IBD Diagnostics.","authors":"Aart Mookhoek, Pieter Sinonque, Mariangela Allocca, Dan Carter, Arzu Ensari, Marietta Iacucci, Uri Kopylov, Bram Verstockt, Daniel C Baumgart, Nurulamin M Noor, Alaa El-Hussuna, Kapil Sahnan, Urko M Marigorta, Daniele Noviello, Peter Bossuyt, Gianluca Pellino, Alessandra Soriano, Jan de Laffolie, Marco Daperno, Tim Raine, Isabelle Cleynen, Shaji Sebastian","doi":"10.1093/ecco-jcc/jjaf133","DOIUrl":"https://doi.org/10.1093/ecco-jcc/jjaf133","url":null,"abstract":"<p><p>In this review, a comprehensive overview of the current state of artificial intelligence (AI) research in Inflammatory Bowel Disease (IBD) diagnostics in the domains of endoscopy, radiology and histology is presented. Moreover, key considerations for development of AI algorithms in medical image analysis are discussed. AI presents a potential breakthrough in real-time, objective and rapid endoscopic assessment, with implications for predicting disease progression. It is anticipated that, by harmonising multimodal data, AI will transform patient care through early diagnosis, accurate patient profiling and therapeutic response prediction. The ability of AI in cross-sectional medical imaging to improve diagnostic accuracy, automate and enable objective assessment of disease activity and predict clinical outcomes highlights its transformative potential. AI models have consistently outperformed traditional methods of image interpretation, particularly in complex areas such as differentiating IBD subtypes, identifying disease progression and complications. The use of AI in histology is a particularly dynamic research field. Implementation of AI algorithms in clinical practice is still lagging, a major hurdle being the lack of a digital workflow in many pathology institutes. Adoption is likely to start with implementation of automatic disease activity scoring. Beyond matching pathologist performance, algorithms may teach us more about IBD pathophysiology. While AI is set to substantially advance IBD diagnostics, various challenges such as heterogeneous datasets, retrospective designs and assessment of different endpoints must be addressed. Implementation of novel standards of reporting may drive an increase in research quality and overcome these obstacles.</p>","PeriodicalId":94074,"journal":{"name":"Journal of Crohn's & colitis","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839466","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}