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OBJECTIVE: Ulcerative colitis and Crohn's disease are chronic inflammatory diseases and represent the two most important types of inflammatory bowel diseases (IBD), while spondyloarthritis (SpA) comprises a heterogeneous group of systemic inflammatory chronic rheumatic diseases, including peripheral SpA and axial SpA. Joint manifestations are the most commonly observed extraintestinal manifestations, and they can precede or not the diagnosis of IBD. Notably, in women, misdiagnoses of IBD as irritable bowel syndrome and SpA as fibromyalgia are common, leading to delayed diagnoses, increased disease burden, and poorer prognoses. This narrative review emphasizes the critical role of diagnostic tools in facilitating early referrals of IBD patients with suspected SpA and vice versa to rheumatologists and gastroenterologists, respectively. Special attention is given to the multidisciplinary approach for more effective management of these conditions, particularly in female patients. METHODS: In this narrative review, we critically evaluated the literature on this topic, focusing on papers written in English that address female issues in IBD and SpA. RESULTS: IBD and SpA are chronic inflammatory disorders often occurring in the same patients. Female patients are often misdiagnosed, and this delay in diagnosis is associated with a higher disease burden and a poorer prognosis. CONCLUSIONS: A multidisciplinary approach is needed to enable early referral between gastroenterologists and rheumatologists, as this means a better prognosis for patients with a reduction in the economic and social burden associated with IBD and SpA.
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Enfermedades Inflamatorias del Intestino , Espondiloartritis , Humanos , Femenino , Espondiloartritis/diagnóstico , Espondiloartritis/complicaciones , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/complicaciones , Pronóstico , Diagnóstico Tardío , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/terapia , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/terapia , Errores Diagnósticos , Diagnóstico Diferencial , Factores Sexuales , Derivación y Consulta , Fibromialgia/diagnóstico , Síndrome del Colon Irritable/diagnósticoRESUMEN
Spondyloarthritis is an umbrella term for a heterogeneous group of chronic inflammatory diseases affecting the spine and/or peripheral joints, often associated with extra-articular manifestations, such as psoriasis, uveitis, and inflammatory bowel disease...
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Espondiloartritis , Humanos , Femenino , Espondiloartritis/diagnóstico , Enfermedades Inflamatorias del Intestino/diagnóstico , Factores SexualesRESUMEN
Background: Lymphocytes play a key role in the pathogenesis of inflammatory bowel disease (IBD) and are widely explored as promising prognostic indicators. We aimed to outline the existing evidences on the capability of lymphocyte subpopulations to predict disease progression and treatment response in patients with IBD. Methods: The protocol for this review was registered in PROSPERO (registration ID: CRD 42022364126). Systematic retrieval was conducted using PubMed, Embase, and Web of Science databases. Original articles on the prognostic value of lymphocyte subsets in IBD published up to April 8, 2023 were eligible for inclusion. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. Results: Twenty studies were ultimately included: eight evaluated the prediction of disease progression and 12 focused on the prediction of treatment response. According to the Newcastle-Ottawa Scale, three studies were of high quality, 16 were of moderate quality, and only one was of low quality. T-cell subpopulations, including CD4+ T cells, CD8+ T cells, and γδ T cells, are revealed to have prognostic capacity. Transmembrane tumor necrosis factor α-bearing lymphocytes, CD4+ T cells, CD8+ T cells, and Plasma cells are found to have the potential to predict the response to anti-TNFα agents. In contrast memory T cells, CD4+ T cells, and naïve B cells may predict the response to vedolizumab. Conclusions: This systematic review identified several potential lymphocyte subset-related predictors. If verified in large cohort prospective studies, these findings could aid clinical decision-making. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022364126.
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Progresión de la Enfermedad , Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/inmunología , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/diagnóstico , Pronóstico , Subgrupos Linfocitarios/inmunología , Subgrupos Linfocitarios/metabolismo , Resultado del Tratamiento , Anticuerpos Monoclonales HumanizadosRESUMEN
BACKGROUND: The role of cytomegalovirus infection as an opportunistic pathogen in exacerbating ulcerative colitis and its response to treatment remain a topic of ongoing debate. Clinicians encounter numerous challenges, including the criteria for differentiating between an acute ulcerative colitis flare and true cytomegalovirus colitis, the diagnostic tests for identifying cytomegalovirus colitis, and determining the appropriate timing for initiating antiviral therapy. CASE PRESENTATION: A 28-year-old Syrian female with a seven-year history of pancolitis presented with worsening bloody diarrhea, abdominal pain, and tenesmus despite ongoing treatment with azathioprine, mesalazine, and prednisolone. She experienced a new flare of acute severe ulcerative colitis despite recently completing two induction doses of infliximab (5 mg/kg) initiated four weeks prior for moderate-to-severe ulcerative colitis. She had no prior surgical history. Her symptoms included watery, bloody diarrhea occurring nine to ten times per day, abdominal pain, and tenesmus. Initial laboratory tests indicated anemia, leukocytosis, elevated C-reactive protein (CRP) and fecal calprotectin levels, and positive CMV IgG. Stool cultures, Clostridium difficile toxin, testing for Escherichia coli and Cryptosporidium, and microscopy for ova and parasites were all negative. Sigmoidoscopy revealed numerous prominent erythematous area with spontaneous bleeding. Biopsies demonstrated CMV inclusions confirmed by immunohistochemistry, although prior biopsies were negative. We tapered prednisolone and azathioprine and initiated ganciclovir at 5 mg/kg for ten days, followed by valganciclovir at 450 mg twice daily for three weeks. After one month, she showed marked improvement, with CRP and fecal calprotectin levels returning to normal. She scored one point on the partial Mayo score. The third induction dose of infliximab was administered on schedule, and azathioprine was resumed. CONCLUSION: Concurrent cytomegalovirus infection in patients with inflammatory bowel disease presents a significant clinical challenge due to its associated morbidity and mortality. Diagnosing and managing this condition is particularly difficult, especially regarding the initiation or continuation of immunosuppressive therapies.
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Colitis , Infecciones por Citomegalovirus , Femenino , Humanos , Adulto , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/tratamiento farmacológico , Colitis/virología , Colitis/diagnóstico , Colitis/complicaciones , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Citomegalovirus/aislamiento & purificación , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/diagnóstico , Antivirales/uso terapéutico , BiopsiaRESUMEN
Serological biomarkers have been rapidly progressing as non-invasive tests for the early detection of inflammatory bowel disease (IBD). Procalcitonin (PCT) is a novel acute-phase reactant protein that is elevated in the inflammatory process, especially in bacterial infections. This study aimed to review the diagnostic value of PCT in IBD activity. However, there were controversies about the role of PCT in the detecting of IBD disease activity. Studies showed varied diagnostic cut-points (ranging from 0.13 to 1.0â¯ng/dl) and sensitivity up to 93â¯%. Although the clear role of PCT as a valuable diagnostic marker was not identified in determining disease activity, PCT measurement in addition to other inflammatory markers can improve the diagnostic value of these markers. Moreover, further studies are required to confirm PCT's value in distinguishing IBD disease activity.
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Biomarcadores , Enfermedades Inflamatorias del Intestino , Polipéptido alfa Relacionado con Calcitonina , Humanos , Polipéptido alfa Relacionado con Calcitonina/sangre , Biomarcadores/sangre , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/sangre , PronósticoRESUMEN
This letter evaluates the article by Gravina et al on ChatGPT's potential in providing medical information for inflammatory bowel disease patients. While promising, it highlights the need for advanced techniques like reasoning + action and retrieval-augmented generation to improve accuracy and reliability. Emphasizing that simple question and answer testing is insufficient, it calls for more nuanced evaluation methods to truly gauge large language models' capabilities in clinical applications.
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Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/terapia , Reproducibilidad de los Resultados , Educación del Paciente como Asunto , LenguajeRESUMEN
In this editorial, we comment on the article by Stafie et al. Inflammatory bowel disease (IBD) constitutes a cluster of chronic and progressive inflammatory disorders affecting the digestive system. IBD can impede an individual's capacity to perform daily activities, hinder work productivity, limit physical capabilities, and negatively impact medical outcomes. Although physical activity and structured exercise programs are becoming increasingly important in many chronic inflammatory diseases, they are not being sufficiently implemented in IBD patients. Effective prevention of future disability and drug dependence in IBD patients requires timely diagnosis and treatment of musculoskeletal problems, including sarcopenia, as well as decreased muscle strength, aerobic capacity, and bone mineral density. To improve treatment outcomes for IBD patients, it is crucial to develop individualized rehabilitation programs tailored to their unique needs. Equally critical is the active participation of pertinent departments in this process. It is imperative to highlight the significance of creating a personalized rehabilitation program with a multidisciplinary approach in IBD management.
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Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/rehabilitación , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/fisiopatología , Terapia por Ejercicio/métodos , Resultado del Tratamiento , Actividades Cotidianas , Sarcopenia/rehabilitación , Sarcopenia/diagnóstico , Sarcopenia/fisiopatología , Ejercicio Físico , Fuerza Muscular , Calidad de VidaRESUMEN
The diagnosis of inflammatory bowel disease (IBD) in children and the need to distinguish between subtypes (Crohn's disease (CD) and ulcerative colitis (UC)) requires lengthy investigative and invasive procedures. Non-invasive, rapid, and cost-effective tests to support these diagnoses are needed. Faecal volatile organic compounds (VOCs) are distinctive in IBD. VOC profiles can be rapidly determined using a gas chromatography-sensor device (OdoReader©). In an inception-cohort of children presenting with suspected IBD, we directly compared the diagnostic fidelity of faecal calprotectin (FCP, a non-specific protein marker of intestinal inflammation) with OdoReader© VOC profiles of children subsequently diagnosed with IBD with matched controls diagnosed with other gastrointestinal conditions. The OdoReader© was 82% (95% confidence interval 75-89%) sensitive and 71% (61-80%) specific but did not outperform FCP (sensitivity 93% (77-99%) and specificity 86% (67-96%); 250 µg/g FCP cut off) in the diagnosis of IBD from other gastrointestinal conditions when validated in a separate sample from the same cohort. However, unlike FCP and better than other similar technologies, the OdoReader© could distinguish paediatric CD from UC (up to 88% (82-93%) sensitivity and 80% (71-89%) specificity in the validation set) and justifies further validation in larger studies. A non-invasive test based on VOCs could help streamline and limit invasive investigations in children.
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Colitis Ulcerosa , Enfermedad de Crohn , Heces , Compuestos Orgánicos Volátiles , Humanos , Colitis Ulcerosa/diagnóstico , Niño , Enfermedad de Crohn/diagnóstico , Compuestos Orgánicos Volátiles/análisis , Masculino , Femenino , Heces/química , Adolescente , Cromatografía de Gases/métodos , Preescolar , Enfermedades Inflamatorias del Intestino/diagnóstico , Diagnóstico Diferencial , Complejo de Antígeno L1 de Leucocito/análisis , Biomarcadores/análisis , Técnicas Biosensibles/métodos , Técnicas Biosensibles/instrumentaciónRESUMEN
BACKGROUND AND STUDY AIMS: Close monitoring of disease activity in IBD patients is essential to avoid long term complications. Although endoscopic assessment is the ideal monitoring tool, the usage of noninvasive biomarkers is more practical and patient friendly. We aimed to study the performance of Interleukin-6(IL-6) and Serum Amyloid A(SAA) as serum biomarkers in assessment of the disease activity of IBD patients in correlation to C-reactive protein (CRP), Fecal Calprotectin (FC) and endoscopic indices. METHODS: 83 IBD (26 CD and 57 UC) patients on stable treatment regimen were recruited. Serum markers included CRP, CBC, IL-6, SAA were analyzed, together with FC. These markers were compared with the endoscopic and clinical disease parameters. Harvey-Bradshaw Index (HBI) and the Simple Clinical Colitis Activity Index (SCCAI) were used to assess clinical activity in CD and UC patients, respectively. Endoscopic activity was recorded using the Simple Endoscopic Score (SES) for Crohn's disease or the Mayo Endoscopic Score (MES) for ulcerative colitis. RESULTS: In prediction of disease activity, IL-6, SAA and CRP demonstrated good area under receiver operating characteristics (AUC) (>0.7), with FC being the best (0.94) for endoscopically active disease (P < 0.01). Combining FC and IL-6 or SAA improved its discriminative accuracy with an AUC (â¼0.96). CONCLUSIONS: FC most accurately predicts endoscopic disease activity in IBD patients, in comparison to other studied serological biomarkers. The serum IL-6 and SAA are potential predictors of endoscopic disease activity, and they might be valuable for assessment of disease activity. Finally, a composite score of FC and SAA or IL-6 can increased its diagnostic accuracy.
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Biomarcadores , Proteína C-Reactiva , Enfermedad de Crohn , Heces , Interleucina-6 , Complejo de Antígeno L1 de Leucocito , Proteína Amiloide A Sérica , Índice de Severidad de la Enfermedad , Humanos , Proteína Amiloide A Sérica/análisis , Proteína Amiloide A Sérica/metabolismo , Complejo de Antígeno L1 de Leucocito/análisis , Interleucina-6/sangre , Heces/química , Femenino , Masculino , Adulto , Biomarcadores/sangre , Biomarcadores/análisis , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/sangre , Enfermedad de Crohn/metabolismo , Persona de Mediana Edad , Colitis Ulcerosa/sangre , Colitis Ulcerosa/diagnóstico , Colonoscopía , Adulto Joven , Curva ROC , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/sangre , Enfermedades Inflamatorias del Intestino/metabolismoRESUMEN
BACKGROUND: Faecal biomarkers can be used to assess inflammatory bowel disease (IBD). AIM: To explore the performance of some promising biomarkers in diagnosing and predicting disease course in IBD. METHODS: We included 65 patients with treatment-naïve, new-onset Crohn's disease (CD), 90 with ulcerative colitis (UC), 67 symptomatic controls (SC) and 41 healthy controls (HC) in this prospective observational study. We analysed faecal samples for calprotectin (FC), myeloperoxidase (MPO), human neutrophil lipocalin (HNL), eosinophil cationic protein ECP and eosinophil-derived neurotoxin (EDN) and compared markers among groups. We assessed the diagnostic capability of biomarkers with receiver operating characteristic curves. Clinical disease course was determined for each patient with IBD and analysed the association with biomarkers by logistic regression. RESULTS: All markers were elevated at inclusion in patients with IBD compared with HC (p < 0.001) and SC (p < 0.001). FC (AUC 0.85, 95% CI: 0.79-0.89) and MPO (AUC 0.85, 95% CI: 0.80-0.89) showed the highest diagnostic accuracy in distinguishing IBD from SC. The diagnostic ability of biomarkers differed between IBD subtypes with the highest performance for FC and MPO in CD. The diagnostic accuracy was further improved by combining FC and MPO (p = 0.02). Levels of FC, MPO and HNL at inclusion were predictive of an aggressive disease course with MPO showing the strongest association (p = 0.006). CONCLUSIONS: This study provides new insight into the diagnostic and prognostic capability of neutrophil and eosinophil biomarkers in IBD and suggests that MPO, alone or in combination with FC, may add to the diagnostic power of faecal biomarkers.
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Biomarcadores , Colitis Ulcerosa , Neurotoxina Derivada del Eosinófilo , Heces , Complejo de Antígeno L1 de Leucocito , Peroxidasa , Humanos , Biomarcadores/análisis , Biomarcadores/metabolismo , Femenino , Masculino , Heces/química , Adulto , Estudios Prospectivos , Complejo de Antígeno L1 de Leucocito/análisis , Persona de Mediana Edad , Peroxidasa/metabolismo , Colitis Ulcerosa/diagnóstico , Neurotoxina Derivada del Eosinófilo/análisis , Neurotoxina Derivada del Eosinófilo/metabolismo , Enfermedad de Crohn/diagnóstico , Proteína Catiónica del Eosinófilo/análisis , Proteína Catiónica del Eosinófilo/metabolismo , Adulto Joven , Enfermedades Inflamatorias del Intestino/diagnóstico , Estudios de Casos y Controles , Curva ROC , Progresión de la Enfermedad , Valor Predictivo de las PruebasAsunto(s)
Proctitis , Humanos , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Diagnóstico Diferencial , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/complicaciones , Proctitis/diagnóstico , Proctitis/tratamiento farmacológicoRESUMEN
INTRODUCTION: Endoscopy plays a fundamental role in inflammatory bowel disease (IBD), and becomes essential in diagnosis, treatment monitoring, and detection and management of complications. MATERIALS AND METHODS: The Pan American Crohn's and Colitis Organization (PANCCO) and the Inter-American Society of Endoscopy (SIED) appointed 22 Latin American experts in IBD to develop a consensus study using the modified Delphi method, based on the best available evidence. A working group of 22 members from 9 countries identified 15 topics and formulated 98 statements, who participated in 2 rounds of voting. It was defined as agreement of ≥80% of experts for each statement. RESULTS: After the voting of all the statements, 8 statements were obtained that did not reach 80% consensus among the participants, so the questions were reconsidered in the Coordinating Committee of the consensus with the participation of the expert reviewers of these questions and 7 final statements were voted again by all the experts in a second round and 1 was eliminated with consensus. After two rounds of voting, the experts reached consensus with literature review with the best available evidence, the most important issues were developed with scientific evidence supporting each of the statements around the topic of endoscopy in IBD. CONCLUSIONS: Consensus statements were developed and based on the best available evidence about endoscopy in inflammatory bowel disease.
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Técnica Delphi , Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Endoscopía Gastrointestinal/normas , Enfermedad de Crohn/diagnóstico , América Latina , Sociedades Médicas , ConsensoRESUMEN
Inflammatory bowel disease is a chronic immune-mediated disorder with a relapsing and remitting course. It leads to disabling gastrointestinal symptoms, low quality of life, and a significant burden for healthcare utilization and associated costs. Therefore, non-invasive biomarkers are needed for early diagnosis and follow up to avoid the complications of invasive diagnostic procedures. Calgranulin C is a calcium binding protein with proinflammatory properties. The aim of this study was to evaluate the role of serum calgranulin C as a non-invasive biomarker for diagnosis and prediction of activity in comparison to different biomarkers and endoscopic activity scores in inflammatory bowel disease. The study included 80 inflammatory bowel disease patients (50 Ulcerative colitis and 30 Chron's patients) and 20 normal controls. Complete blood picture, C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin and serum calgranulin C were measured. Colonoscopies with histopathological examination were done and different activity scoring systems assessed. Among ulcerative colitis group, serum calgranulin C was statistically significantly higher in comparison to control group [723.640±529.055 ng/ml versus 80.850±24.416 ng/ml]. Depending on the American college of gastroenterology ulcerative colitis activity index, fecal calprotectin and serum calgranulin C were statistically significantly higher among moderate to severe ulcerative colitis than those with mild activity and those in remission (p < 0.001, for both). Regarding Crohn's disease group, serum calgranulin C was statistically significantly higher in comparison to control group [759.233±797.963 ng/ml versus 80.850±24.416 ng/mL]. Depending on Crohn's disease activity index, both serum calgranulin C and fecal calprotectin were statistically significantly higher among active disease than those in remission (p < 0.001, for both). In conclusion, serum calgranulin C could be used as a non-invasive marker to predict activity and severity and to ensure remission among inflammatory bowel disease patients.
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Enfermedades Inflamatorias del Intestino , Complejo de Antígeno L1 de Leucocito , Proteína S100A12 , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biomarcadores/sangre , Colitis Ulcerosa/sangre , Colitis Ulcerosa/diagnóstico , Heces/química , Enfermedades Inflamatorias del Intestino/sangre , Enfermedades Inflamatorias del Intestino/diagnóstico , Complejo de Antígeno L1 de Leucocito/sangre , Índice de Severidad de la Enfermedad , Proteína S100A12/sangreRESUMEN
Background: Platelets play a significant role in the innate and adaptive processes of immunity and inflammation. Inflammatory bowel disease (IBD) is an autoimmune disease that is widely understood to be caused by a combination of genetic predisposition, aberrant immune responses, etc. Methods: To examine the relationships between genetically determined platelet indices and IBD, we conducted a Mendelian randomization (MR) study. Data associated with platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) were used from the UK Biobank. The outcome data, including IBD, Crohn's disease (CD), ulcerative colitis (UC), were from the FinnGen database. The inverse variance-weighted (IVW), MR-Egger, weighted median methods were used for MR analyses. Results: The MR estimations from the IVW approach show a significant connection between PLT and IBD. Similarly, PCT and IBD have a relationship following the IVW and MR-Egger approaches. While PLT and PCT have strong relationships with CD, according to the findings of all three approaches respectively. Nevertheless, PDW was the only relevant indicator of UC. The only significant result was IVW's. Conclusion: Our findings suggest that the fluctuation of platelet indicators is of great significance in the development of IBD. PLT and PCT have a close association with IBD and CD, respectively; PDW only has a connection with UC. Platelets play an important role in the progression of IBD (UC, CD).
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Plaquetas , Enfermedades Inflamatorias del Intestino , Análisis de la Aleatorización Mendeliana , Humanos , Plaquetas/inmunología , Enfermedades Inflamatorias del Intestino/sangre , Enfermedades Inflamatorias del Intestino/genética , Enfermedades Inflamatorias del Intestino/diagnóstico , Recuento de Plaquetas , Volúmen Plaquetario Medio , Predisposición Genética a la Enfermedad , Enfermedad de Crohn/genética , Enfermedad de Crohn/sangre , Enfermedad de Crohn/inmunología , Polimorfismo de Nucleótido SimpleRESUMEN
OBJECTIVES: This study described disease characteristics and long-term outcomes in patients diagnosed with very early onset inflammatory bowel disease (VEOIBD) (diagnosed before 6 years of age) and infantile-IBD (before 2 years). METHODS: Cases from 21 centers worldwide diagnosed with VEOIBD (2008-2018), with minimum 2 years of follow-up, were retrospectively reviewed. RESULTS: The cohort included 243 patients (52% males, median follow-up of 5.8 [range 2-18] years, including 69 [28%]) with infantile-IBD. IBD subtypes included Crohn's disease (CD), ulcerative colitis (UC), or IBD-unclassified (IBDU) in 30%, 59%, and 11%, respectively. Among patients with CD, 94% had colonic involvement, and among patients with UC/IBDU, 75% had pancolitis. Patients with infantile-IBD presented with higher rates of IBDU, lower hemoglobin and albumin levels, and higher C-reactive protein, and had lower response rates to first-induction therapy and corticosteroids therapy (P < .05 for all). Colectomy and diversion surgeries were performed in 11% and 4%, respectively, with no significant differences between age groups. Corticosteroid-free remission rates were 74% and 78% after 3 and 5 years, respectively, and 86% at end of follow-up. Genetic testing was performed in 96 (40%) patients. Among tested population, 15 (16%) were identified with monogenic disease. This group demonstrated lower response rates to induction therapies, higher rates of surgical intervention, and higher rates of major infections (P < .05 for all). CONCLUSIONS: Patients with VEOIBD, including infantile-IBD, exhibit low rate of complications and surgical interventions at the long term. Patients with monogenic IBD are at risk for more severe disease course.
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Edad de Inicio , Humanos , Masculino , Femenino , Estudios Retrospectivos , Preescolar , Lactante , Adolescente , Niño , Enfermedades Inflamatorias del Intestino/genética , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Inflamatorias del Intestino/terapia , Estudios de Seguimiento , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/terapia , Enfermedad de Crohn/genética , Enfermedad de Crohn/cirugía , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/terapia , Colitis Ulcerosa/genética , Colitis Ulcerosa/cirugía , Colitis Ulcerosa/epidemiologíaRESUMEN
In inflammatory bowel diseases (IBDs), such as Crohn's disease (CD) and ulcerative colitis (UC), the immune system relentlessly attacks intestinal cells, causing recurrent tissue damage over the lifetime of patients. The etiology of IBD is complex and multifactorial, involving environmental, microbiota, genetic, and immunological factors that alter the molecular basis of the organism. Among these, the microbiota and immune cells play pivotal roles; the microbiota generates antigens recognized by immune cells and antibodies, while autoantibodies target and attack the intestinal membrane, exacerbating inflammation and tissue damage. Given the altered molecular framework, the analysis of multiple molecular biomarkers in patients proves exceedingly valuable for diagnosing and prognosing IBD, including markers like C reactive protein and fecal calprotectin. Upon detection and classification of patients, specific treatments are administered, ranging from conventional drugs to new biological therapies, such as antibodies to neutralize inflammatory molecules like tumor necrosis factor (TNF) and integrin. This review delves into the molecular basis and targets, biomarkers, treatment options, monitoring techniques, and, ultimately, current challenges in IBD management.
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Biomarcadores , Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/metabolismo , Enfermedades Inflamatorias del Intestino/terapia , Enfermedades Inflamatorias del Intestino/inmunología , AnimalesRESUMEN
Inflammatory Bowel Disease includes Crohn's Disease and Ulcerative Colitis. Currently, diagnosing involves a series of current diagnostic methods that are invasive, time-consuming, and expensive. Near-infrared spectroscopy and aquaphotomics can detect changes in biofluids and thus have the potential to diagnose disease. This study aimed to investigate the diagnostic ability of near infrared spectroscopy and aquaphotomics for Inflammatory Bowel Disease and its types. This method used blood plasma and saliva samples absorbance spectrum and multivariate analysis with the Principal Component Analysis and, Linear Discriminant Analysis, Quadratic Discriminant Analysis, and Support Vector Machine in the range 1300-1600 nm and 12 water absorbance bands in this range, separately. In the near-infrared range, total accuracy of 100% led to the separation of the healthy group and Inflammatory Bowel Disease and then the separation of the healthy group and patients with Ulcerative Colitis and Crohn's Disease. The aquaphotomics approach was used to investigate the changes in the 12 water absorbance bands and their impact on the accuracy of the diagnostic method. Aquaphotomics also detected 100% of the mentioned samples. We achieved a fast, accurate, non-invasive method based on near-infrared spectroscopy and aquaphotomics to diagnose Inflammatory Bowel Disease and its types using blood plasma or saliva samples. The current study found that monitoring blood plasma or saliva using near-infrared spectra offers an opportunity to thoroughly investigate biofluids and changes in their water spectral patterns caused by complex physiological changes due to Inflammatory Bowel Disease and its types, and to visualize these changes using aquagram.