Editorial Board Members’ Collection Series: Inflammatory Bowel Disease

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: 25 December 2024 | Viewed by 4979

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Special Issue Information

Dear Colleagues,

Inflammatory Bowel Disease: looking to new horizons

Inflammatory bowel diseases (IBD) are characterised by active chronic inflammation in the gastrointestinal tract with huge morbidity for patients and large healthcare costs. IBD can be classified as Crohn’s disease (CD), ulcerative colitis (UC), or IBD unclassified (IBDU). Now seen as a global condition, prevalence of this incurable condition continues to increase. Whilst much is known about IBD, there remain many gaps in our understanding of the pathogenesis of IBD, variable approaches to the management of IBD, and inconsistent outcomes. This Collection Series aims to draw together articles focusing on current aspects of IBD and key aspects looming on the horizon. These might include therapeutic agents, such as the use of small molecules (JAK kinase inhibitors and S1P receptor modulators), and therapeutic approaches, such as treat-to-target or combination trials. Additional articles could focus on aspects of the pathogenesis of IBD (with regard to environmental factors, host immune responses, or the intestinal microbiome) and outcomes.

Prof. Dr. Laurent Peyrin-biroulet
Prof. Dr. Andrew Day
Guest Editors

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Keywords

  • inflammatory bowel diseases
  • Crohn’s disease
  • ulcerative colitis
  • JAK kinase inhibitors
  • SIP receptor modulators
  • therapeutic approaches

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Published Papers (4 papers)

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Review

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9 pages, 234 KiB  
Review
The Role of Topical Tacrolimus in the Management of Inflammatory Bowel Disease: A Comprehensive Review
by Danial Khayatan, Daniel A. Lemberg and Andrew S. Day
J. Clin. Med. 2024, 13(18), 5518; https://doi.org/10.3390/jcm13185518 - 18 Sep 2024
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Abstract
Management of ulcerative colitis and Crohn’s disease, the main subtypes of inflammatory bowel disease (IBD), focuses on the induction and maintenance of remission. Tacrolimus, a member of a group of drugs termed calcineurin inhibitors, may have a role in the medical management of [...] Read more.
Management of ulcerative colitis and Crohn’s disease, the main subtypes of inflammatory bowel disease (IBD), focuses on the induction and maintenance of remission. Tacrolimus, a member of a group of drugs termed calcineurin inhibitors, may have a role in the medical management of IBD when given either systemically or topically. This review aimed to evaluate the available data focusing on the use of topical tacrolimus in the management of IBD. Reports of the use of topical tacrolimus in IBD were extracted from databases up to 31 May 2024. Topical tacrolimus therapy appears to have reasonable efficacy in the induction and maintenance of remission in patients with refractory IBD, with an acceptable safety profile. Overall, the available data are supportive of the use of topical tacrolimus in selected patients. Further comparative clinical studies are required to more fully delineate the role of this drug. Full article
18 pages, 1468 KiB  
Review
The Microbiome in Inflammatory Bowel Disease
by Aranzazu Jauregui-Amezaga and Annemieke Smet
J. Clin. Med. 2024, 13(16), 4622; https://doi.org/10.3390/jcm13164622 - 7 Aug 2024
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Abstract
The management of patients with inflammatory bowel disease (IBD) aims to control inflammation through the use of immunosuppressive treatments that target various points in the inflammatory cascade. However, the efficacy of these therapies in the long term is limited, and they often are [...] Read more.
The management of patients with inflammatory bowel disease (IBD) aims to control inflammation through the use of immunosuppressive treatments that target various points in the inflammatory cascade. However, the efficacy of these therapies in the long term is limited, and they often are associated with severe side effects. Although the pathophysiology of the disease is not completely understood, IBD is regarded as a multifactorial disease that occurs due to an inappropriate immune response in genetically susceptible individuals. The gut microbiome is considered one of the main actors in the development of IBD. Gut dysbiosis, characterised by significant changes in the composition and functionality of the gut microbiota, often leads to a reduction in bacterial diversity and anti-inflammatory anaerobic bacteria. At the same time, bacteria with pro-inflammatory potential increase. Although changes in microbiome composition upon biological agent usage have been observed, their role as biomarkers is still unclear. While most studies on IBD focus on the intestinal bacterial population, recent studies have highlighted the importance of other microbial populations, such as viruses and fungi, in gut dysbiosis. In order to modulate the aberrant immune response in patients with IBD, researchers have developed therapies that target different players in the gut microbiome. These innovative approaches hold promise for the future of IBD treatment, although safety concerns are the main limitations, as their effects on humans remain unknown. Full article
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16 pages, 355 KiB  
Review
Evolution of a Pathogenic Microbiome
by Pui Yin Wong, Carmen Yip, Daniel A. Lemberg, Andrew S. Day and Steven T. Leach
J. Clin. Med. 2023, 12(22), 7184; https://doi.org/10.3390/jcm12227184 - 20 Nov 2023
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Abstract
The process of microbiome development arguably begins before birth. Vertical transmission of bacteria from the mother to the infant is a keystone event in microbiome development. Subsequent to birth, the developing microbiome is vulnerable to influence from a wide range of factors. Additionally, [...] Read more.
The process of microbiome development arguably begins before birth. Vertical transmission of bacteria from the mother to the infant is a keystone event in microbiome development. Subsequent to birth, the developing microbiome is vulnerable to influence from a wide range of factors. Additionally, the microbiome can influence the health and development of the host infant. This intricate interaction of the gastrointestinal microbiome and the host has been described as both symbiotic and dysbiotic. Defining these terms, a symbiotic microbiome is where the microbiome and host provide mutual benefit to each other. A pathogenic microbiome, or more precisely a gastrointestinal microbiome associated with disease, is increasing described as dysbiotic. This review seeks to investigate the factors that contribute to evolving a disease-causing or ‘dysbiotic’ microbiome. This review covers the development of the gastrointestinal microbiome in infants, the interaction of the microbiome with the host, and its contribution to host immunity and investigates specific features of the gastrointestinal microbiome that are associated with disease. Full article
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Other

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14 pages, 1331 KiB  
Systematic Review
Fistulizing Perianal Disease as a First Manifestation of Crohn’s Disease: A Systematic Review and Meta-Analysis
by Liesbeth Jozefien Munster, Giulia Louise Emilia Mönnink, Susan van Dieren, Marco William Mundt, Geert Renaat Alfons Maria D’Haens, Willem Adrianus Bemelman, Christianne Johanna Buskens and Jarmila Dagmara Wendelien van der Bilt
J. Clin. Med. 2024, 13(16), 4734; https://doi.org/10.3390/jcm13164734 - 12 Aug 2024
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Abstract
Background: Incidences of perianal fistulas (PAFs) as a first manifestation of Crohn’s disease (CD) vary widely in the literature. Aim: To analyse the percentage of patients with a PAF preceding CD diagnosis and assess the time to diagnosis. Methods: A systematic [...] Read more.
Background: Incidences of perianal fistulas (PAFs) as a first manifestation of Crohn’s disease (CD) vary widely in the literature. Aim: To analyse the percentage of patients with a PAF preceding CD diagnosis and assess the time to diagnosis. Methods: A systematic literature search was conducted. Studies reporting on patients with a PAF preceding CD diagnosis were identified. Primary outcomes were the (weighted) percentage of patients with CD with a PAF preceding CD and their time to CD diagnosis. Secondary outcomes were the (weighted) percentage of patients with CD with a PAF preceding CD diagnosis in predefined patient subgroups, including (1) sex (men vs. women), (2) ethnicity (Asian vs. non-Asian), and (3) age (paediatric (0–18 y) and patients with elderly onset CD (>60 y) vs. adult patients (18–60 y)). Results: Seventeen studies were included (34,030 patients with CD). In the overall CD population, a PAF preceded CD in 8.6% [95%CI; 5.72; 12.71] with a weighted mean time to CD diagnosis of 45.9 (31.3) months. No studies reported details on sex differences in patients with a PAF as a manifesting sign of CD. In Asian populations, a PAF preceded CD in 17.66% [95%CI; 11.45; 26.25], which was significantly higher when compared with non-Asians (4.99% [95%CI; 3.75; 6.60], OR:3.99, p < 0.0001). In adolescents, an incidence of 9.17% [95%CI; 5.92; 13.93] was found with significantly lower incidences in paediatric patients (6.38% [95%CI; 1.84; 19.85], OR:0.53, p < 0.0001), and elderly-onset patients (3.77% [95%CI; 1.68; 8.25], OR:0.44, p = 0.0035). Conclusions: This systematic review shows that in the literature, almost 10% of patients present with a PAF as a first manifestation of CD, with a mean time to diagnosis of almost four years. These results emphasise that increased clinical awareness is needed. Full article
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