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Clinical Advances in Chronic Intestinal Diseases Treatment
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Clinical Advances in Chronic Intestinal Diseases Treatment

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: closed (31 December 2021) | Viewed by 30713

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Jose E. Mesonero

E-Mail Website
Guest Editor
Instituto de Investigacion Sanitaria de Aragon (IIS Aragon), 50009 Zaragoza, Spain
Interests: gastroenterology; gastrointestinal disorders; endocrinology; intestinal transport; PRRs; serotonin
Special Issues, Collections and Topics in MDPI journals
Dr. Eva Latorre

E-Mail Website
Guest Editor
Instituto de Investigacion Sanitaria de Aragon (IIS Aragon), 50009 Zaragoza, Spain
Interests: microbiota; PRRs; gut–brain axis; innate immunity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the past two decades, several advances have been made in the management of patients with chronic intestinal diseases from both evaluative and therapeutic perspectives. Among other chronic intestinal pathologies, irritable bowel syndrome (IBS), involving gut-brain axis alterations that causes abdominal pain, bloating, and alternating diarrhea and constipation, and inflammatory bowel disease (IBD), characterized by chronic inflammation of the gastrointestinal tract, are the best known and with the highest incidence and prevalence. Both chronic conditions, with significant overlap in terms of symptoms, pathophysiology, and treatment, need to be managed over long term and sometimes with overlay treatments.

However, new clinical approaches with novel mechanisms of action could offer new options for treatment of chronic intestinal diseases not optimally caracterized and controlled. Integration of novel approaches into clinical practice together with emerging strategies for management of chronic intestinal diseases will allow physicians to improve patient outcomes and potentially alter the progressive course of these diseases. Chronic intestinal diseases have a significant effect on the quality of life of affected patients and the increasing number of cases worldwide is a growing concern. Because of the overall burden of these diseases and its multifactorial etiology, efforts have been made to improve the medical management of these conditions.

This special issue aims to gather in one collection reviews and original contributions to illustrate the state of the art to provide novel approaches for the treatment of chronic intestinal diseases and the envisaged future in the management of these pathologies. On behalf of the Journal of Clinical Medicine you are cordially invited to contribute an article to the Special Issue “Clinical Advances in Chronic Intestinal Diseases Treatment”. Research articles, Reviews and Communications are welcome.

Dr. Jose E. Mesonero
Dr. Eva Latorre
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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

  • Functional Intestinal Disorders
  • Inflammatory Bowel Disease
  • Irritable Bowel Syndrome
  • Crohn’s Disease
  • Ulcerative Colitis
  • Celiac Disease
  • Microbiota
  • Gut-brain axis
  • Biosimilars
  • Alternative pharmacological treatments

Published Papers (7 papers)

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Editorial

Jump to: Research, Review

3 pages, 182 KiB  
Editorial
Special Issue “Clinical Advances in Chronic Intestinal Diseases Treatment”
by Eva Latorre and Jose Emilio Mesonero
J. Clin. Med. 2022, 11(5), 1258; https://doi.org/10.3390/jcm11051258 - 25 Feb 2022
Viewed by 1126
Abstract
During the last decades, the management of patients with chronic intestinal diseases has experienced remarkable progress from both diagnostic and therapeutic point of view [...] Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)

Research

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17 pages, 743 KiB  
Article
Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu
by María José García, Montserrat Rivero, José Miranda-Bautista, Iria Bastón-Rey, Francisco Mesonero, Eduardo Leo-Carnerero, Diego Casas-Deza, Carmen Cagigas Fernández, Albert Martin-Cardona, Ismael El Hajra, Nerea Hernández-Aretxabaleta, Isabel Pérez-Martínez, Esteban Fuentes-Valenzuela, Nuria Jiménez, Cristina Rubín de Célix, Ana Gutiérrez, Cristina Suárez Ferrer, José María Huguet, Agnes Fernández-Clotet, María González-Vivó, Blanca Del Val, Jesús Castro-Poceiro, Luigi Melcarne, Carmen Dueñas, Marta Izquierdo, David Monfort, Abdel Bouhmidi, Patricia Ramírez De la Piscina, Eva Romero, Gema Molina, Jaime Zorrilla, Cristina Calvino-Suárez, Eugenia Sánchez, Andrea Nuñez, Olivia Sierra, Beatriz Castro, Yamile Zabana, Irene González-Partida, Saioa De la Maza, Andrés Castaño, Rodrigo Nájera-Muñoz, Luis Sánchez-Guillén, Micaela Riat Castro, José Luis Rueda, José Manuel Benítez, Pedro Delgado-Guillena, Carlos Tardillo, Elena Peña, Santiago Frago-Larramona, María Carmen Rodríguez-Grau, Rocío Plaza, Pablo Pérez-Galindo, Jesús Martínez-Cadilla, Luis Menchén, Manuel Barreiro-De Acosta, Rubén Sánchez-Aldehuelo, María Dolores De la Cruz, Luis Javier Lamuela, Ignacio Marín, Laura Nieto-García, Antonio López-San Román, José Manuel Herrera, María Chaparro, Javier P. Gisbert and on behalf of the Young Group of GETECCUadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(19), 4402; https://doi.org/10.3390/jcm10194402 - 26 Sep 2021
Cited by 11 | Viewed by 3421
Abstract
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk [...] Read more.
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
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10 pages, 1089 KiB  
Article
Clinical Outcomes of Pediatric Chronic Intestinal Pseudo-Obstruction
by Dayoung Ko, Hee-Beom Yang, Joong Youn and Hyun-Young Kim
J. Clin. Med. 2021, 10(11), 2376; https://doi.org/10.3390/jcm10112376 - 28 May 2021
Cited by 8 | Viewed by 2531
Abstract
Chronic intestinal pseudo-obstruction (CIPO) is an extremely rare condition with symptoms of recurrent intestinal obstruction without any lesions. The outcomes of pediatric CIPO and predictors for the outcomes have not yet been well established. We analyzed the clinical outcomes and associated factors for [...] Read more.
Chronic intestinal pseudo-obstruction (CIPO) is an extremely rare condition with symptoms of recurrent intestinal obstruction without any lesions. The outcomes of pediatric CIPO and predictors for the outcomes have not yet been well established. We analyzed the clinical outcomes and associated factors for the outcomes of pediatric CIPO. We retrospectively reviewed 66 primary CIPO patients diagnosed between January 1985 and December 2017. We evaluated parenteral nutrition (PN) factors such as PN duration, PN use over 6 months, home PN, and mortality as outcomes. We selected onset age, presence of urologic symptoms, pathologic type, and involvement extent as predictors. The early-onset CIPO was found in 63.6%, and 21.2% of the patients presenting with urologic symptoms. Of the 66 patients, 47 and 11 had neuropathy and myopathy, respectively. The generalized involvement type accounted for 83.3% of the cases. At the last follow-up, 24.2% of the patients required home PN management. The mean duration of PN was 11.8 ± 21.0 months. The overall mortality rate of primary CIPO was 18.2%. PN factors were predicted by the urologic symptoms and extent of involvement. However, mortality was predicted by pathologic type. The onset age was not significantly associated with the outcomes. CIPO with urologic symptoms and generalized CIPO had poor PN outcomes. Myopathy is suggested as a predictor of mortality in children with primary CIPO. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
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Review

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7 pages, 377 KiB  
Review
Selecting the Best Combined Biological Therapy for Refractory Inflammatory Bowel Disease Patients
by Eduard Brunet Mas and Xavier Calvet Calvo
J. Clin. Med. 2022, 11(4), 1076; https://doi.org/10.3390/jcm11041076 - 18 Feb 2022
Cited by 7 | Viewed by 3718
Abstract
Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. The combination of two biological therapies (CoT) seems [...] Read more.
Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. The combination of two biological therapies (CoT) seems a reasonable alternative, and has been increasingly tested in very difficult cases. The present review suggests that CoT seems to be safe and effective for refractory and severely ill IBD patients. Ustekinumab plus vedolizumab and vedolizumab plus anti-TNF were the most used CoTs for Crohn’s disease. For ulcerative colitis, the most used CoTs were vedolizumab plus anti-TNF and vedolizumab plus tofacitinib. The aforesaid CoTs have shown good efficacy and few adverse events have been reported. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
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10 pages, 249 KiB  
Review
Selective Forms of Therapy in the Treatment of Inflammatory Bowel Diseases
by Anna Kofla-Dłubacz, Katarzyna Akutko, Elżbieta Krzesiek, Tatiana Jamer, Joanna Braksator, Paula Grębska, Tomasz Pytrus and Andrzej Stawarski
J. Clin. Med. 2022, 11(4), 994; https://doi.org/10.3390/jcm11040994 - 14 Feb 2022
Cited by 5 | Viewed by 1678
Abstract
Selective interference with the functioning of the immune system consisting of the selective blockade of pro-inflammatory factors is a modern, promising, and developing strategy for the treatment of diseases resulting from dysregulation of the immune system, including inflammatory bowel disease. Inhibition of the [...] Read more.
Selective interference with the functioning of the immune system consisting of the selective blockade of pro-inflammatory factors is a modern, promising, and developing strategy for the treatment of diseases resulting from dysregulation of the immune system, including inflammatory bowel disease. Inhibition of the TNF alpha pathway, group 12/23 cytokines, and lymphocyte migration is used in the treatment of severe or moderate ulcerative colitis and Crohn’s disease. Intracellular signal transduction by influencing the phosphorylation of SAT (signal transducer and activator of transcription) proteins remains in clinical trials. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
22 pages, 416 KiB  
Review
How to Choose the Biologic Therapy in a Bio-naïve Patient with Inflammatory Bowel Disease
by Viviana Laredo, Carla J. Gargallo-Puyuelo and Fernando Gomollón
J. Clin. Med. 2022, 11(3), 829; https://doi.org/10.3390/jcm11030829 - 04 Feb 2022
Cited by 11 | Viewed by 3683
Abstract
The availability of biologic therapies in inflammatory bowel disease (IBD) is increasing significantly. This represents more options to treat patients, but also more difficulties in choosing the therapies, especially in the context of bio-naïve patients. Most evidence of safety and efficacy came from [...] Read more.
The availability of biologic therapies in inflammatory bowel disease (IBD) is increasing significantly. This represents more options to treat patients, but also more difficulties in choosing the therapies, especially in the context of bio-naïve patients. Most evidence of safety and efficacy came from clinical trials comparing biologics with placebo, with a lack of head-to-head studies. Network meta-analysis of biologics and real-world studies have been developed to solve this problem. Despite the results of these studies, there are also other important factors to consider before choosing the biologic, such as patient preferences, comorbidities, genetics, and inflammatory markers. Given that resources are limited, another important aspect is the cost of biologic therapy, since biosimilars are widely available and have been demonstrated to be effective with a significant decrease in costs. In this review, we summarize the evidence comparing biologic therapy in both Crohn´s disease (CD) and ulcerative colitis (UC) in different clinical situations. We also briefly synthesize the evidence related to predictors of biologic response, as well as the biologic use in extraintestinal manifestations and the importance of the drug-related costs. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
22 pages, 962 KiB  
Review
Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management
by Mónica Gros, Belén Gros, José Emilio Mesonero and Eva Latorre
J. Clin. Med. 2021, 10(15), 3429; https://doi.org/10.3390/jcm10153429 - 31 Jul 2021
Cited by 42 | Viewed by 13282
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications [...] Read more.
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Intestinal Diseases Treatment)
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