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Biomedicines
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Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches
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Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 6300

Special Issue Editors

Dr. Maria Manuela Estevinho

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Guest Editor
1. Department of Gastroenterology, Vila Nova de Gaia Espinho Hospital Center, Vila Nova de Gaia, Portugal
2. Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
Interests: inflammatory bowel disease; endoscopy
Special Issues, Collections and Topics in MDPI journals
Dr. Fernando Magro

E-Mail Website
Guest Editor
1. Department of Gastroenterology, São João Hospital University Centre, Porto, Portugal
2. Unidade de Farmacologia Clínica, São João Hospital University Centre, Porto, Portugal
3. Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
Interests: gastroenterology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are lifelong gastrointestinal tract disorders whose prevalence is projected to reach 1% by 2030. The unpredictable remitting–relapsing course is a defining characteristic, significantly contributing to the burden of IBD. Remarkable advancements in the understanding of IBDs have been made in recent decades. It is now evident that IBDs arise from a complex interplay of genetic, environmental, and microbial factors, leading to dysregulated immune responses. However, there are still several unresolved aspects that limit timely diagnosis and therapeutic options, impacting patients' prognosis and quality of life. Therefore, it is crucial to encourage research that addresses the existing knowledge gaps. In this Special Issue, we invite original research or review articles focused on various topics related to IBD, including:

  • Mechanisms underlying IBD pathogenesis;
  • Disease monitoring;
  • Biomarkers;
  • Pharmacological innovations (new targets and combination therapy);
  • Endoscopic treatment;
  • Risk stratification and individualized therapy;
  • Management of extraintestinal manifestations;
  • Comorbidities in patients with IBD

Dr. Maria Manuela Estevinho
Dr. Fernando Magro
Guest Editors

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. Biomedicines 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 2600 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

  • bowel inflammation
  • crohn’s disease
  • endoscopy
  • inflammatory bowel disease
  • targeted therapy
  • ulcerative colitis

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Related Special Issue

Published Papers (5 papers)

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Research

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22 pages, 9006 KiB  
Article
Immunohistochemistry Analysis in Inflammatory Bowel Disease—Should We Bring to Light Interleukin-10?
by Christopher Pavel, Mircea Mihai Diculescu, Madalina Ilie, Oana-Mihaela Plotogea, Vasile Sandru, Valentin Enache, Dan-Ionut Gheonea, Alexandra Jichitu, Alexandru Constantinescu, Robert-Emmanuel Serban, Cosmin Viorel Bogu, Horia-Dan Liscu and Alex-Emilian Stepan
Biomedicines 2025, 13(2), 406; https://doi.org/10.3390/biomedicines13020406 - 7 Feb 2025
Cited by 1 | Viewed by 999
Abstract
Background/Objectives: Inflammatory bowel diseases (IBDs) are chronic intestinal disorders with an unpredictable course. In parallel with the advent of new biologic therapies targeting specific interleukin pathways, end-point targets have become more stringent, aiming for mucosal and even histologic healing. Methods: We conducted a [...] Read more.
Background/Objectives: Inflammatory bowel diseases (IBDs) are chronic intestinal disorders with an unpredictable course. In parallel with the advent of new biologic therapies targeting specific interleukin pathways, end-point targets have become more stringent, aiming for mucosal and even histologic healing. Methods: We conducted a prospective study assessing immunohistochemical (IHC) parameters in 46 IBD patients treated with biologic therapy. A similar IHC analysis was performed for comparison with a cohort of 10 “non-IBD” patients. Results: The highest integrated optical density (IOD) of TNF-α was observed in patients with dysplasia, abscesses, mucin depletion and basal plasmacytosis. Non-responders had higher pre- and post-treatment TNF-α expression in both UC and CD compared to responders. On the contrary, the same analysis conducted in the subpopulation treated with anti-TNF-α therapy (Infliximab and Adalimumab) did not reveal a substantial difference in TNF-α expression between responders and non-responders. High pre-treatment interleukin-10 expression was associated with biologic therapy failure, histological inflammatory activity and longer disease duration. Conclusions: Pre-treatment assessment of IL-10 might be a useful tool for identifying a high-risk subset of IBD patients and determining a more aggressive therapy and intensive monitoring strategy. Full article
(This article belongs to the Special Issue Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches)
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18 pages, 1780 KiB  
Article
Avolition Characterizes the Chronic Fatigue Experienced in Quiescent Inflammatory Bowel Disease
by Tristan Gabriel-Segard, Margherita Boltri, Mathilde Barrau, Catherine Massoubre, Stéphane Paul and Xavier Roblin
Biomedicines 2025, 13(1), 125; https://doi.org/10.3390/biomedicines13010125 - 7 Jan 2025
Viewed by 835
Abstract
Background and Aims: Avolition is a symptom responsible for a high burden in patients suffering from psychiatric diseases. It refers to a motivation loss for initiating and maintaining goal-directed activities, often called fatigue by patients. Fatigue is a widespread complaint of patients suffering [...] Read more.
Background and Aims: Avolition is a symptom responsible for a high burden in patients suffering from psychiatric diseases. It refers to a motivation loss for initiating and maintaining goal-directed activities, often called fatigue by patients. Fatigue is a widespread complaint of patients suffering from inflammatory bowel disease (IBD), significantly impacting patients’ well-being, even during the quiescent stage of the disease. We here address the hypothesis that fatigue experienced by IBD patients is associated with motivational impairment. Methods: Patients presenting IBD (n = 110) in a quiescent stage of Crohn’s disease (CD) (n = 60) and ulcerative colitis (UC) (n = 50) were enrolled and classified following their declared experience of fatigue (n = 58) or not (n = 52). Patients were phenotyped using self-administered scales for fatigue experience, bowel disease disability, quality of life and mental health symptoms. Results: The self-administered negative symptoms scale scores identified avolition as a specific feature of fatigue experience: fatigued vs. no-fatigue in the CD group (3.806 vs. 2.103; p = 0.003) and in the UC group (2.815 vs. 1.174; p = 0.003). This difference is independent of current depressive disorder and previous history of depressive disorder. Avolition associates and correlates with the experience of fatigue (r = 0.49) in multivariate analysis. Conclusions: To tackle the question of fatigue in IBD, research should consider investigating the biological mechanisms implicating intestinal physiopathology of IBD in the impairment of brain structure involved in motivation. This may open new fields for treatment in targeting structures of the brain reward system. Full article
(This article belongs to the Special Issue Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches)
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13 pages, 1621 KiB  
Article
Enhancing Calprotectin’s Predictive Power as a Biomarker of Endoscopic Activity in Ulcerative Colitis: A Machine Learning Use Case
by Mihaela Dranga, Cătălina Mihai, Otilia Gavrilescu, Cristina Cijevschi Prelipcean and Iolanda Valentina Popa
Biomedicines 2024, 12(3), 475; https://doi.org/10.3390/biomedicines12030475 - 20 Feb 2024
Viewed by 1689
Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. [...] Read more.
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. Using machine learning (ML) to combine fecal calprotectin with other clinical or biological tests can significantly enhance the non-invasive prediction of endoscopic disease activity (EDA) in UC. Aim: To prove that by fusing fecal calprotectin with other clinical data into an ML model, the performance of the non-invasive prediction of EDA can be significantly improved. Methods: We conducted a prospective, observational, single-center study encompassing 103 patients diagnosed with UC. We employed multilayer perceptron models as the core ML algorithm for predicting EDA. For the constructed models, we utilized the varImp function from the caret library in R to assess the significance of each variable in predicting the outcome. Results: Calprotectin as a sole predictor obtained an accuracy of 70% and an area under the curve (AUC) of 0.68. Combining calprotectin with the list of selected predictors that were fed to the MLP models improved accuracy and the AUC. The accuracy of the algorithm on the test set was 85%. Similarly, the AUC increased to 0.93. This is the first study to propose the use of calprotectin as a predictor in an ML model to estimate UC endoscopic disease activity. Conclusion: The deployment of this ML model can furnish doctors and patients with valuable evaluation of endoscopic disease activity which can be highly beneficial for individuals with UC who need long-term treatment. Full article
(This article belongs to the Special Issue Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches)
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20 pages, 3592 KiB  
Article
Interrelation of Hypoxia-Inducible Factor-1 Alpha (HIF-1 α) and the Ratio between the Mean Corpuscular Volume/Lymphocytes (MCVL) and the Cumulative Inflammatory Index (IIC) in Ulcerative Colitis
by Ioan Sabin Poenariu, Lidia Boldeanu, Bogdan Silviu Ungureanu, Daniel Cosmin Caragea, Oana Mariana Cristea, Vlad Pădureanu, Isabela Siloși, Anca Marinela Ungureanu, Răzvan-Cristian Statie, Alina Elena Ciobanu, Dan Ionuț Gheonea, Eugen Osiac and Mihail Virgil Boldeanu
Biomedicines 2023, 11(12), 3137; https://doi.org/10.3390/biomedicines11123137 - 24 Nov 2023
Cited by 3 | Viewed by 1487
Abstract
We intended to investigate the presence and medical application of serum hypoxia-inducible factor-1 alpha (HIF-1α) along with the already known systemic inflammatory markers and the new one’s inflammatory indices, the proportion of mean corpuscular volume and lymphocytes (MCVL) and the cumulative inflammatory index [...] Read more.
We intended to investigate the presence and medical application of serum hypoxia-inducible factor-1 alpha (HIF-1α) along with the already known systemic inflammatory markers and the new one’s inflammatory indices, the proportion of mean corpuscular volume and lymphocytes (MCVL) and the cumulative inflammatory index (IIC), for patients with ulcerative colitis (UC). We sought to establish correlations that may be present between the serum levels of HIF-1α and these inflammatory indices, as well as their relationship with disease activity and the extent of UC, which can provide us with a more precise understanding of the evolution, prognosis, and future well-being of patients. Serum samples were collected from 46 patients diagnosed with UC and 23 controls. For our assessment of the serum levels of HIF-1α, we used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Thus, for HIF-1α we detected significantly higher values in more severe and more extensive UC. When it came to MCVL and IIC, we observed statistically significant differences between the three groups being compared (Severe, Moderate, and Mild). Our study highlighted that HIF-1α correlated much better with a disease activity score, MCVL, and IIC. With MCVL and IIC, a strong and very strong correlation had formed between them and well-known inflammation indices. By examining the ROC curves of the analyzed parameters, we recognized that TWI (accuracy of 83.70%) provides the best discrimination of patients with early forms of UC, followed by HIF-1α (73.90% accuracy), MCVL (70.90% accuracy), and PLR (70.40%). In our study, we observed that HIF-1α, MCVL, and PLR had the same sensitivity (73.33%) but HIF-1α had a much better specificity (60.87% vs. 58.70%, and 54.35%). Also, in addition to the PLR, HIF-1α and MCVL can be used as independent predictor factors in the discrimination of patients with early forms of UC. Full article
(This article belongs to the Special Issue Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches)
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Review

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13 pages, 226 KiB  
Review
FAPi PET/CT Imaging to Identify Fibrosis in Immune-Mediated Inflammatory Diseases
by Dalia A. Lartey, Lynn A. Schilder, Gerben J. C. Zwezerijnen, Geert R. A. M. D’Haens, Joep Grootjans and Mark Löwenberg
Biomedicines 2025, 13(4), 775; https://doi.org/10.3390/biomedicines13040775 - 22 Mar 2025
Viewed by 462
Abstract
Immune-mediated inflammatory diseases (IMIDs) are characterized by chronic systemic inflammation and multi-organ involvement. Fibrosis formation in IMIDs can cause tissue destruction and subsequently organ malfunction. Fibroblast activation protein inhibitor positron emission tomography/computed tomography (FAPi PET/CT) represents a novel imaging technique that holds great [...] Read more.
Immune-mediated inflammatory diseases (IMIDs) are characterized by chronic systemic inflammation and multi-organ involvement. Fibrosis formation in IMIDs can cause tissue destruction and subsequently organ malfunction. Fibroblast activation protein inhibitor positron emission tomography/computed tomography (FAPi PET/CT) represents a novel imaging technique that holds great potential to visualize in vivo fibrosis. We here provide an overview of available evidence on FAPi PET/CT imaging to visualize fibrosis in various IMIDs, including interstitial lung diseases, immunoglobulin G4-related diseases, cardiovascular diseases, kidney diseases, and gastrointestinal diseases. FAPi PET/CT imaging demonstrates high sensitivity in detecting early fibrosis, correlating with disease severity, across different IMIDs, showing superiority compared to conventional imaging modalities. Although FAPi PET/CT might be a useful tool to assess fibrosis formation, thereby aiding in grading disease severity and staging, future studies should include larger sample sizes in a broad variety of IMIDs with emphasis on the optimization of imaging protocols to further validate its diagnostic value. Full article
(This article belongs to the Special Issue Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches)
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