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Medicina
Special Issues
Ulcerative Colitis: Diagnosis and Management
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Ulcerative Colitis: Diagnosis and Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5731

Special Issue Editor

Dr. Amosy E M'Koma

E-Mail Website
Guest Editor
Department of Biochemistry, Cancer Biology, Neuroscience and Pharmacology, Meharry Medical College School of Medicine, Nashville, TN 37208-3500, USA
Interests: inflammatory bowel disease; ulcerative colitis; Crohn's colitis; indeterminate colitis; endoscopic medicine; molecular diagnostics; biomarker; colonic ileal metaplasia; precision diagnostics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The goal of this Special Issue is to share valuable knowledge and the most recent developments in innovative methodologies for the diagnosis and management of ulcerative colitis.

Timely diagnosis is central to optimal UC care given the association between diagnostic ambiguity, delay, and disease outcomes in IBD. Although the interval between symptom onset and gastrointestinal consultation referral by a primary care physician is by far the greatest contributor to the overall time to diagnosis, delayed and/or incorrect diagnoses are common, which are serious unmet challenges in IBD. Current methods for diagnosing colonic IBD are painstakingly inaccurate. Up to 15% of IBD cases are classified as indeterminate colitis (IC) when the established criteria for ulcerative colitis (UC) and Crohn's colitis (CC) are non-definitive. In another 15% of IBD cases, authentic CC is not evident prior to colectomy. Therefore, 30% of colonic IBD patients are inaccurately administered confounding treatment regimens. Much of the diagnostic uncertainty arises from overlapping features that make CC appear like UC. The standard curative surgical procedure for treating UC is RPC-IPAA. Crohn’s colitis is a relative contraindication to RPC-IPAA because of the higher rate of complications and pouch failure, even in highly selected patients. It is important, therefore, to categorize inexact IC diagnoses into authentic UC or CC to provide recommended therapeutic intervention, thus improving health outcomes and quality of life while reducing medical complications and unnecessary pharmaceuticals, surgeries, and healthcare costs.

This Special Issue aims to focus on innovative, comprehensive and multidisciplinary approaches to the clinical diagnosis and treatment of ulcerative colitis. Biological research studies are also welcome. This Special Issue also encourages the submission of evidence-based original research works or literature reviews to promote the adoption of best practices and research as well as patient and specialized healthcare provider education.

Dr. Amosy E M'Koma
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory bowel disease
  • ulcerative colitis
  • Crohn's colitis
  • indeterminate colitis
  • endoscopic medicine
  • molecular diagnostics
  • biomarker
  • colonic ileal metaplasia
  • precision diagnostics

Published Papers (3 papers)

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Research

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16 pages, 3451 KiB  
Article
Effects of the Antioxidant Quercetin in an Experimental Model of Ulcerative Colitis in Mice
by George Kottakis, Katerina Kambouri, Alexandra Giatromanolaki, Georgia Valsami, Nikolaos Kostomitsopoulos, Alexandra Tsaroucha and Michael Pitiakoudis
Medicina 2023, 59(1), 87; https://doi.org/10.3390/medicina59010087 - 31 Dec 2022
Cited by 3 | Viewed by 1829
Abstract
Background and Objectives: Quercetin, a member of the flavanol family found in many fruits, vegetables, leaves and grains has been found to have a wide range of biological effects on human physiology. The aim of this study was to investigate the effects [...] Read more.
Background and Objectives: Quercetin, a member of the flavanol family found in many fruits, vegetables, leaves and grains has been found to have a wide range of biological effects on human physiology. The aim of this study was to investigate the effects of quercetin, when administered orally in the form of the water-soluble inclusion complex with hydroxypropyl-b-cyclodextrin (Que-HP-β-CD), in an experimental model of ulcerative colitis in mice. Materials and Methods: Animals received either Dextran Sodium Sulphate (DSS), to induce colitis, + Que-HP-β-CD (Group A), DSS alone (Group B) or no intervention (control, Group C) for 7 days. All animals were weighed daily, and evaluation of colitis was performed using the Disease Activity Index (DAI). On day 7 a blood sample was taken from all animals, they were then euthanised, the large intestine was measured, and histological and immunochemical analyses were performed. Results: The DAI demonstrated an increase over time for the groups receiving DSS (Groups A and B) compared with the control group (Group C), with a significant degree of protection being observed in the group that also received quercetin (Group A): The DAI over time slope for Group B was higher than that for Group A by 0.26 points/day (95% Cl 0.20–0.33, p < 0.01). Weight calculations and immunohistochemistry results validated the DAI findings. Conclusions: In conclusion, the administration of quercetin in an ulcerative colitis model in mice presents a therapeutic/prophylactic potential that warrants further investigation. Full article
(This article belongs to the Special Issue Ulcerative Colitis: Diagnosis and Management)
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Review

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19 pages, 2910 KiB  
Review
Inflammatory Bowel Disease-Associated Colorectal Cancer: Translational and Transformational Risks Posed by Exogenous Free Hemoglobin Alpha Chain, a By-Product of Extravasated Erythrocyte Macrophage Erythrophagocytosis
by Maya A. Bragg, Williams A. Breaux and Amosy E. M’Koma
Medicina 2023, 59(7), 1254; https://doi.org/10.3390/medicina59071254 - 6 Jul 2023
Viewed by 1802
Abstract
Colonic inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC) and Crohn’s colitis (CC). Patients with IBD are at increased risk for colitis-associated colorectal cancer (CACRC) compared to the general population. CACRC is preceded by IBD, characterized by highly heterogenous, pharmacologically incurable, pertinacious, worsening, [...] Read more.
Colonic inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC) and Crohn’s colitis (CC). Patients with IBD are at increased risk for colitis-associated colorectal cancer (CACRC) compared to the general population. CACRC is preceded by IBD, characterized by highly heterogenous, pharmacologically incurable, pertinacious, worsening, and immune-mediated inflammatory pathologies of the colon and rectum. The molecular and immunological basis of CACRC is highly correlated with the duration and severity of inflammation, which is influenced by the exogenous free hemoglobin alpha chain (HbαC), a byproduct of infiltrating immune cells; extravasated erythrocytes; and macrophage erythrophagocytosis. The exogenous free HbαC prompts oxygen free radical-arbitrated DNA damage (DNAD) through increased cellular reactive oxygen species (ROS), which is exacerbated by decreased tissue antioxidant defenses. Mitigation of the Fenton Reaction via pharmaceutical therapy would attenuate ROS, promote apoptosis and DNAD repair, and subsequently prevent the incidence of CACRC. Three pharmaceutical options that attenuate hemoglobin toxicity include haptoglobin, deferoxamine, and flavonoids (vitamins C/E). Haptoglobin’s clearance rate from plasma is inversely correlated with its size; the smaller the size, the faster the clearance. Thus, the administration of Hp1-1 may prove to be beneficial. Further, deferoxamine’s hydrophilic structure limits its ability to cross cell membranes. Finally, the effectiveness of flavonoids, natural herb antioxidants, is associated with the high reactivity of hydroxyl substituents. Multiple analyses are currently underway to assess the clinical context of CACRC and outline the molecular basis of HbαC-induced ROS pathogenesis by exposing colonocytes and/or colonoids to HbαC. The molecular immunopathogenesis pathways of CACRC herein reviewed are broadly still not well understood. Therefore, this timely review outlines the molecular and immunological basis of disease pathogenesis and pharmaceutical intervention as a protective measure for CACRC. Full article
(This article belongs to the Special Issue Ulcerative Colitis: Diagnosis and Management)
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Other

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8 pages, 551 KiB  
Brief Report
Treatment of Ulcerative Colitis: Impact on Platelet Aggregation
by Sasa Peric, Zeljko Todorovic, Nebojsa Zdravkovic, Andjela Gogic, Stefan Simovic, Vesna Grbovic, Mladen Maksic, Stefan Jakovljevic, Olivera Milovanovic and Natasa Zdravkovic
Medicina 2023, 59(9), 1615; https://doi.org/10.3390/medicina59091615 - 7 Sep 2023
Viewed by 1256
Abstract
Background and Objectives: Ulcerative colitis is chronic and/or progressive inflammation of the colorectal mucosa and submucosa and represents one of two major inflammatory bowel diseases. Ulcerative colitis has been associated with increased risk of arteriosus and venous thrombosis. There are numerous factors [...] Read more.
Background and Objectives: Ulcerative colitis is chronic and/or progressive inflammation of the colorectal mucosa and submucosa and represents one of two major inflammatory bowel diseases. Ulcerative colitis has been associated with increased risk of arteriosus and venous thrombosis. There are numerous factors responsible for this; one of them is platelet activation and aggregation. The objective of our study was to determine if different treatment options for ulcerative colitis have an impact on platelet aggregation. Materials and Methods: This research was a prospective, observational study and included 94 newly diagnosed patients with UC divided into four treatment groups. For all patients, we measured platelet aggregability by using an impedance aggregometry method with a multiplate analyzer before and after treatment with infliximab, adalimumab, vedolizumab and azathioprine. A Paired Samples t test was performed in order to determine the difference in platelet aggregability before and after a certain therapy, since the data followed a normal distribution. Taking into account the impact of some clinical characteristics, multiple linear regression was conducted for the purpose of estimating the effect of therapy on the level of reduction in platelet aggregability. Results: All four drugs significantly reduced platelet aggregability. After we excluded the influence of clinical and endoscopic scores and disease localization on the results, we found that infliximab had the greatest anti-platelet activity. Conclusions: In addition to the well-known traditional risk factors for atherosclerosis, activation and aggregation of platelets play a significant role in the development of arterial thrombosis, and our results suggested that therapy use for the treatment of UC, especially infliximab, can have a great impact on cardiovascular morbidity and mortality by decreasing platelet aggregability. Full article
(This article belongs to the Special Issue Ulcerative Colitis: Diagnosis and Management)
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