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Gastroenterology Insights
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Immunological Aspects of Gastrointestinal Diseases
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Immunological Aspects of Gastrointestinal Diseases

A special issue of Gastroenterology Insights (ISSN 2036-7422). This special issue belongs to the section "Gastrointestinal Disease".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 8511

Special Issue Editor

Dr. Tsvetelina Velikova

E-Mail Website
Guest Editor
Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407 Sofia, Bulgaria
Interests: autoimmunity; autoimmune diseases; inflammation; neuroinflammation; biomarkers; cytokines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue of "Immunological Aspects of Gastrointestinal Diseases" intends to be not just a collection of research findings but a platform that actively fosters academic exchange and collaboration within the field of gastrointestinal immunology topics, from fundamental immunology research to clinical applications. By focusing on the immunological dimension of gastrointestinal diseases as well as the intricate interplay between immune mechanisms and the onset, progression, and treatment of gastrointestinal diseases, it consolidates the latest research findings from across the globe.

The gastrointestinal tract's mucosal immune system plays a pivotal role in defending against foreign pathogens, actively interacting with the gut microbiota, and maintaining immune tolerance in the gut. Therefore, this Special Issue will prioritize advancements in the immunological pathogenesis of gastrointestinal diseases, immune modulation strategies, and immunology-based therapeutic approaches. Additionally, it will explore the roles of key elements such as THE gut microbiota, immune cell subsets, and immune molecular networks in gastrointestinal diseases, offering novel insights and directions for disease prevention, diagnosis, and treatment.

Dr. Tsvetelina Velikova
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 250 words) can be sent to the Editorial Office for assessment.

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. Gastroenterology Insights is an international peer-reviewed open access quarterly 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

  • gastrointestinal diseases
  • immunology
  • mucosal immune system
  • intestinal inflammation
  • immune tolerance
  • inflammatory bowel disease (IBD)
  • crohn’s disease
  • ulcerative colitis
  • gut microbiota
  • immunomodulation
  • immunotherapy

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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11 pages, 257 KB  
Article
Assessing Intestinal Inflammation: A Comparison of Immunochromatographic Tests and ELISA for Fecal Calprotectin Detection
by Hassan Ali, Milena Peruhova, Antoaneta Mihova, Georgi V. Vasilev and Tsvetelina Velikova
Gastroenterol. Insights 2026, 17(2), 21; https://doi.org/10.3390/gastroent17020021 - 24 Mar 2026
Viewed by 760
Abstract
Background: Fecal calprotectin (FC) is a well-established, non-invasive biomarker of intestinal inflammation and is widely used to differentiate inflammatory bowel disease (IBD) from functional gastrointestinal disorders. Although enzyme-linked immunosorbent assays (ELISA) remain the reference method, rapid immunochromatographic tests (ICTs) offer important operational [...] Read more.
Background: Fecal calprotectin (FC) is a well-established, non-invasive biomarker of intestinal inflammation and is widely used to differentiate inflammatory bowel disease (IBD) from functional gastrointestinal disorders. Although enzyme-linked immunosorbent assays (ELISA) remain the reference method, rapid immunochromatographic tests (ICTs) offer important operational advantages for point-of-care (POC) diagnostics. However, variability in analytical performance among available ICTs remains a concern. Objective: This study aimed to evaluate the diagnostic accuracy of the CerTest Calprotectin one-step card (CerTest Biotec S.L., Zaragoza, Spain) in comparison with the Actim® Calprotectin lateral flow assay and the reference Calprest® ELISA (Eurospital Diagnostics, Italy). Methods: A total of 128 fresh stool samples from patients clinically suspected of IBD were analyzed in parallel using all three assays. For the reference ELISA (Calprest®), a cutoff value of >40 µg/g was applied according to the manufacturer’s instructions. For discrepant results between assays, a cutoff of 200 ng/mL (equivalent to 200 µg hCp/g stool) was employed for ELISA Calprest® to resolve inconsistencies. The results of the lateral flow assays (CerTest® Calprotectin ICT and Actim® Calprotectin) were interpreted using their respective manufacturer-recommended thresholds. Diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using ELISA as the reference standard. Agreement between methods was assessed using Cohen’s κ coefficient. Results: Using ELISA, 47 of 128 samples (36.7%) exceeded the 40 µg/g cutoff. Compared with the Actim® assay, the CerTest card demonstrated a sensitivity of 88.0% (95% CI: 75.7–95.5), a specificity of 100.0% (95% CI: 95.4–100), and a strong agreement (κ = 0.90). When compared with ELISA, the CerTest assay showed a sensitivity of 87.2% (95% CI: 74.3–95.2), a specificity of 96.3% (95% CI: 89.6–99.2), a PPV of 93.2%, an NPV of 93.2%, and a strong agreement (κ = 0.85). Conclusions: The CerTest Calprotectin one-step card provides a rapid and reliable detection of fecal calprotectin, demonstrating a high sensitivity and specificity that are comparable to both other lateral flow assays and the ELISA reference method. These findings support the use of rapid immunochromatographic testing as a valuable tool for preliminary screening and clinical decision-making in patients suspected of IBD, while acknowledging that histology remains the gold standard for definitive diagnosis. Full article
(This article belongs to the Special Issue Immunological Aspects of Gastrointestinal Diseases)

Review

Jump to: Research

23 pages, 1239 KB  
Review
Immune-Mediated Colitis in the Era of Immune Checkpoint Inhibition: From Mechanisms to Clinical Management
by Cristina Polo Cuadro, Pilar Corsino Roche, Marta Gascón Ruiz, Santiago García López, Carmen Yagüe Caballero, Ana Royo Esteban, Laura Almenara Michelena and Diego Casas Deza
Gastroenterol. Insights 2026, 17(1), 20; https://doi.org/10.3390/gastroent17010020 - 10 Mar 2026
Viewed by 1378
Abstract
Immunotherapy with immune checkpoint inhibitors (ICIs) has represented a major breakthrough in the treatment of multiple solid and hematological malignancies, significantly improving survival and tumor control. However, the blockade of immune regulatory pathways such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell [...] Read more.
Immunotherapy with immune checkpoint inhibitors (ICIs) has represented a major breakthrough in the treatment of multiple solid and hematological malignancies, significantly improving survival and tumor control. However, the blockade of immune regulatory pathways such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) is associated with the development of immune-related adverse events, among which immune-mediated colitis (IMC) constitutes one of the most relevant gastrointestinal complications due to its frequency, potential severity, and impact on the continuation of oncologic treatment. IMC typically presents with diarrhea, abdominal pain, and gastrointestinal bleeding, and may progress to severe, life-threatening forms. Its incidence varies according to the type of ICI, and is higher with CTLA-4 inhibitors and particularly elevated with combination therapies. The pathophysiology is complex and multifactorial, involving dysregulated activation of proinflammatory T lymphocytes, impairment of immune regulatory mechanisms, disruption of the intestinal epithelial barrier, and a key modulatory role of the gut microbiota. Diagnosis requires a high index of clinical suspicion and relies on endoscopy with biopsies, given the poor correlation between clinical severity and endoscopic or histological findings. Fecal biomarkers, such as calprotectin and lactoferrin, are useful for risk stratification and disease monitoring. Treatment is based on a stepwise immunosuppressive approach, with corticosteroids as first-line therapy and biologic agents such as infliximab or vedolizumab in refractory cases. Emerging strategies, including fecal microbiota transplantation, offer new therapeutic perspectives. This article provides a comprehensive review of the current evidence on the epidemiology, pathophysiology, diagnosis, and management of IMC, as well as future challenges and opportunities in its clinical management. Full article
(This article belongs to the Special Issue Immunological Aspects of Gastrointestinal Diseases)
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11 pages, 290 KB  
Review
The Association Between Crohn’s Disease and Patient Response to Yeast: A Review of the Literature
by Xavier Zonna, Conor Banta and Nariman Hossein-Javaheri
Gastroenterol. Insights 2024, 15(4), 1064-1074; https://doi.org/10.3390/gastroent15040073 - 10 Dec 2024
Cited by 5 | Viewed by 5018
Abstract
Inflammatory bowel disease represents a wide range of pathologies and disease states including Crohn’s Disease (CD) and Ulcerative colitis (UC). Despite extensive research, the exact immunopathogenesis of Crohn’s disease remains unclear, but a variety of studies over the years have pointed to yeast [...] Read more.
Inflammatory bowel disease represents a wide range of pathologies and disease states including Crohn’s Disease (CD) and Ulcerative colitis (UC). Despite extensive research, the exact immunopathogenesis of Crohn’s disease remains unclear, but a variety of studies over the years have pointed to yeast as a potential source antigen of uncertain significance. The aim of this review is to summarize the current literature investigating the association between Crohn’s disease patients and their responses to yeast. To do this, we performed a literature review by looking at clinical and translational research regarding the immunopathogenesis of Crohn’s disease, yeast and its associated biomarkers, and overall patient response to dietary yeast published between 1 January 1990 and 1 October 2024 that were indexed on PubMed and Google Scholar with the majority written in English. It was found that antibodies against Saccharomyces cerevisiae (ASCA) have proven to be highly specific for CD during the workup of IBD and may have diagnostic value for the purpose of excluding ulcerative colitis. For CD patients, there appears to be a dysregulated immune response to antigens like yeast that results in abnormal mucosal permeability and thus increases antigen presentation to the immune system. In addition, ASCA and its immunoglobulin modifications have been shown to have significant potential in the prediction of CD onset and disease course. Interestingly, although other abnormally structured antibodies can be found in CD patients’ serum for years preceding diagnosis, there appears to be no relation between ASCA and dietary yeast sensitivity by CD patients. In conclusion, significant research efforts have been made in recent years to explore the role of diet in the disease course and management of patients with Crohn’s disease. The immunological role of antigens including yeast in CD is complex and may represent an important pathogenetic factor in addition to influencing the specific phenotype of the disease. Unfortunately, no single specific diet is superior for the management of IBD, and individualized patient treatment by experts in the field is best for adjunctive therapy. New studies characterizing the microbiome of CD patients and also using immune markers/gene modifications to predict disease outcomes have shown to be quite promising. However, further research is required to investigate the CD yeast response and its role in the pathogenesis, diagnosis and treatment of CD. Full article
(This article belongs to the Special Issue Immunological Aspects of Gastrointestinal Diseases)
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