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Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 5276

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Prof. Dr. Ewa Malecka-Wojciesko

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Guest Editor

Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
Interests: pancreatic diseases; inflammatory bowel diseases; esophageal; stomach; intestinal dysfunctions
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Special Issue Information

Dear Colleagues,

Inflammatory bowel disease (IBD) includes mainly ulcerative colitis and Crohn’s disease, which are chronic, progressive diseases.

IBD management is complicated and includes mesalasine, steroids, immunosuppressants, and many new biologic drugs, such as anti-tumor necrosis factor-alpha (TNF-α) agents, anti-integrin agents, anti-interleukin (IL) 12-23 agents, and non-biologic small molecules. The number of available biologics is rapidly growing in recent years and their choice depends on IBD clinical course, previous treatments, including biologics, potential adverse effects, accompanying diseases, and patient’s preferences. Optimal treatment should aim, on the one hand, at clinical remission, endoscopic and histopathologic healing, and prolonged response and, on the other hand, at side effects and complication avoidance.

This Special Issue is dedicated to showcasing the latest clinical advancements in inflammatory bowel disease (IBD). We invite researchers and clinicians to submit their original research articles and reviews that contribute to the understanding, diagnosis, treatment, and management of IBD.

Prof. Dr. Ewa Malecka-Wojciesko
Guest Editor

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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.

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Keywords

inflammatory bowel disease (IBD)
ulcerative colitis
Crohn’s disease
gut inflammation
bowel perforation

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19 pages, 802 KB

Open AccessArticle

Gut Microbiota Alterations and Dysbiosis Patterns in Pediatric Inflammatory Bowel Disease: Clinical Correlations and Therapeutic Impact

by Anda-Maria Beca, Roxana Folescu, Adina Teodora Crăciun, Laura Olariu, Ileana Enatescu, Bianca Belei and Oana Belei

J. Clin. Med. 2026, 15(4), 1589; https://doi.org/10.3390/jcm15041589 - 18 Feb 2026

Viewed by 537

Abstract

Background: Gut microbiota alterations are increasingly recognized as key contributors to the development and clinical course of inflammatory bowel disease (IBD), particularly in pediatric patients, in whom microbial maturation and immune regulation are still evolving. Objective: This study aimed to assess intestinal microbiota composition and dysbiosis severity in pediatric IBD, with comparative analyses according to disease phenotype (Crohn’s disease versus ulcerative colitis) and therapeutic strategy (biologic versus non-biologic treatment). Methods: A prospective cohort of 60 pediatric patients diagnosed with IBD based on Porto criteria was evaluated. Fecal samples were obtained at baseline and after three months of combined standard IBD treatment and adjunct microbiota-targeted therapy, and were analyzed using an AI-assisted microbiota profiling platform. A semi-quantitative dysbiosis score was calculated based on the relative abundance of proinflammatory taxa and depletion of short-chain fatty acid (SCFA)-producing bacteria. Microbial parameters were correlated with clinical and therapeutic variables, including the Organism of Interest metric and the Gut Microbiota Index (GMI). Results: Dysbiosis severity was significantly higher in patients with Crohn’s disease compared with ulcerative colitis (9.65 ± 1.44 vs. 8.42 ± 1.88, p = 0.037). Patients receiving biologic therapy showed a trend toward lower dysbiosis scores and improved microbial indices, although statistical significance was not reached. Severe dysbiosis was identified in 46.7% of the cohort. Strong positive correlations were observed between the dysbiosis score, Organism of Interest metric and GMI (r = 0.68–0.72, p < 0.01). Conclusions: Pediatric IBD is associated with a reproducible dysbiotic profile, more pronounced in Crohn’s disease and partially modulated by biologic therapy. The observed correlations between microbiota-derived indices support their potential utility as complementary markers of intestinal microbial imbalance and disease activity. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies)

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26 pages, 3644 KB

Open AccessArticle

Analysis of Periostin, TGF-β, and SLUG Expression in Inflammatory Bowel Disease in Pediatric Patients and Their Clinical Implications

by Patrycja Sputa-Grzegrzolka, Anna Socha-Banasiak, Aleksandra Piotrowska, Mateusz Olbromski, Monika Mrozowska, Aneta Popiel-Kopaczyk, Aleksandra Gurzkowska, Krzysztof Paczes, Elzbieta Czkwianianc, Hanna Romanowicz, Piotr Dziegiel and Bartosz Kempisty

J. Clin. Med. 2026, 15(2), 845; https://doi.org/10.3390/jcm15020845 - 20 Jan 2026

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Abstract

Background: Pediatric inflammatory bowel disease (pIBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is characterized by chronic intestinal inflammation and fibrosis. Identifying molecular mediators involved in inflammation and tissue repair is critical for improving disease management. Objective: To examine the expression of periostin, TGF-β, and SLUG in pIBD and assess their potential roles in intestinal inflammation, fibrosis, and mucosal healing. Methods: Intestinal biopsies from 33 pediatric patients (11 CD, 22 UC) and 10 healthy controls were analyzed immunohistochemically. Quantitative PCR evaluated POSTN, TGF-β1, and SNAI2 expression in 22 patients and 6 controls. Correlations with fecal calprotectin, the Pediatric Crohn’s Disease Activity Index (PCDAI), and the Pediatric Ulcerative Colitis Activity Index (PUCAI) were determined. Results: Periostin, TGF-β, and SLUG expression were significantly increased in pIBD compared with controls. Periostin levels were higher in CD than in UC. All markers correlated positively at mRNA and protein levels. Notably, periostin showed an inverse correlation with fecal calprotectin and PCDAI scores. Conclusions: Periostin, TGF-β, and SLUG may represent biomarkers of pIBD activity. Periostin appears to mediate inflammation and promote mucosal fibrosis or repair, and its inverse association with disease activity suggests a potential therapeutic role in pIBD. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies)

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12 pages, 353 KB

Open AccessArticle

Characteristics and Clinical Implications of Cytomegalovirus Infection in Patients with Drug-Resistant Ulcerative Colitis Undergoing Colectomy—Data from a Tertiary Referral Center in Poland

by Estera Banasik, Paweł Kosikowski, Izabela Miechowicz, Piotr Zelga, Tomasz Banasiewicz, Agnieszka Dobrowolska and Piotr Eder

J. Clin. Med. 2025, 14(14), 4823; https://doi.org/10.3390/jcm14144823 - 8 Jul 2025

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Abstract

Background/Objectives: This study aimed to assess the frequency, risk factors, and clinical implications of cytomegalovirus (CMV) colitis in patients undergoing colectomy due to refractory ulcerative colitis (UC). Methods: A retrospective analysis was conducted on patients with drug-resistant UC who underwent colectomy at a tertiary referral center between 2009 and 2017. Histological inflammatory activity in surgical specimens was assessed using the Simplified Geboes Score. The presence and density of CMV expression were estimated immunohistochemically. Preoperative clinical, biochemical, and endoscopic data, as well as the short- and long-term postoperative disease courses, were evaluated in relation to the presence of CMV colitis at the time of surgery. Results: CMV colitis was identified in 14% (7/49) of patients. The CMV-positive group exhibited significantly shorter disease durations and higher C-reactive protein concentrations at the time of surgery. This subgroup also demonstrated consistently numerically higher steroid use, both in terms of the usage frequency and cumulative treatment duration. Patients with concomitant CMV colitis had lower likelihoods of stoma closure and restoration of gastrointestinal continuity in the long-term. Conclusions: Concomitant CMV colitis is not uncommon in patients with treatment-refractory UC. Testing for CMV should be considered, particularly in individuals with a short-term, dynamic, and aggressive disease course unresponsive to standard therapy, especially steroids. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies)

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12 pages, 235 KB

Open AccessArticle

Quality of Life in Patients with Inflammatory Bowel Diseases Is Associated with Affective Temperament Traits: A Cross-Sectional Survey of a Polish Clinical Sample

by Anna Mokrowiecka, Magdalena Kopczynska, Alina Borkowska and Ewa Malecka-Wojciesko

J. Clin. Med. 2025, 14(3), 1018; https://doi.org/10.3390/jcm14031018 - 5 Feb 2025

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Abstract

Background: Affective temperaments can be considered the subclinical manifestations of affective and stress-related disorders, which could have a relationship with many chronic diseases. The purpose of this study was to explore the influence of affective temperament traits on disease-specific quality of life in patients with ulcerative colitis (UC) and Crohn’s disease (CD), two types of inflammatory bowel disease (IBD). Methods: The patients completed the Temperament Evaluation of the Memphis, Pisa, Paris, San Diego-Auto-questionnaire (TEMPS-A), which is the 110-item self-reported assessment for five dimensions of temperament: depressive, cyclothymic, hyperthymic, irritable, and anxious, already validated in Poland. For comprehensive assessment of the health-related quality of life (HRQoL), the Inflammatory Bowel Disease Questionnaire (IBDQ) was applied. Results: The study included 116 patients with IBD-61 with UC and 55 with CD, with mean age 43 years, in remission, without serious mental or medical co-morbidities. Mean HRQoL in patients with IBD was poor and mean IBDQ scores were 145, despite clinical remission. A significant negative correlation was found between HRQoL in all the IBDQ domains and TEMPS-A traits: D (p < 0.001), C (p < 0.01), I (p < 0.05), and A (p < 0.001). No significant correlation between hyperthymic temperament and IBDQ scores was found. Conclusions: Poor quality of life in IBD could be associated with affective temperament. Affective temperament traits should be taken into account when identifying patients at risk of worse IBD course and further introducing personalized therapy. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies)

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14 pages, 1236 KB

Open AccessSystematic Review

Fexuprazan and Esomeprazole in Patients with Disorders Associated with Acid Reflux: A Comprehensive Review and Meta-Analysis of Randomized Controlled Trials

by William A. Barzola-Farfán, Carlos Quispe-Vicuña, Oriana Rivera-Lozada, Cesar Bonilla-Asalde and Joshuan J. Barboza

J. Clin. Med. 2026, 15(4), 1434; https://doi.org/10.3390/jcm15041434 - 12 Feb 2026

Viewed by 528

Abstract

Background: This investigation compared the efficacy and safety of fexuprazan 40 mg and esomeprazole 40 mg in patients with acid reflux-related disorders, including erosive esophagitis (EE) and laryngopharyngeal reflux disease (LPRD). Methods: A systematic search was conducted across five databases until January 2025. Primary outcomes included esophageal lesion healing, complete resolution of symptoms (CRS), and 24 h symptom-free days. Meta-analyses used random-effects models with the inverse variance method. The Risk of Bias 2.0 tool and the certainty of evidence (CoE) using GRADE methodology were assessed. Results: Three randomized controlled trials (n = 695) conducted in Asian countries were included. Fexuprazan may have little to no effect compared to esomeprazole on EE healing rate at 4 weeks (RR 1.02, 95% CI 0.93 to 1.12, I² = 0%, n = 2 studies, CoE very low) and 8 weeks. No significant differences were found between treatments regarding CRS at 1 week (RR 1.29; 95% CI: 0.84 to 1.99; I² = 0%; n = 2 studies; CoE very low) and 8 weeks, or in the 24 h symptom-free days at 1 week (MD 2.67 days, 95% CI −2.76 to 8.10, I² = 41%, n = 2 studies, CoE very low) and 8 weeks. Fexuprazan also showed little to no effect on treatment-emergent adverse events (RR 1.00, 95% CI 0.83 to 1.20, I² = 0%, n = 3 studies, CoE very low). Nonetheless, the evidence for all outcomes was rated as very uncertain. Conclusions: Fexuprazan 40 mg may provide similar efficacy compared to esomeprazole 40 mg in EE, with a comparable safety profile to esomeprazole in EE and LPRD patients. However, the evidence is highly uncertain, requiring further studies. Full article

(This article belongs to the Special Issue Inflammatory Bowel Diseases: Clinical Advances and Emerging Therapies)

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