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Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment
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Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to 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 (20 April 2023) | Viewed by 13998

Special Issue Editors

Prof. Dr. Mathurin Fumery

E-Mail Website
Guest Editor
Gastroenterology Department, Amiens University Hospital and Peritox, University Picardie Jules Verne, Amiens, France
Interests: inflammatory bowel disease
Prof. Dr. Anthony Buisson

E-Mail Website
Guest Editor
Gastroenterology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Interests: inflammatory bowel disease; non-invasive monitoring; postoperative recurrence; drug sequencing

Special Issue Information

Dear Colleagues,

Crohn’s disease (CD) and ulcerative colitis (UC) are destructive chronic and disabling diseases that have a negative impact on patients’ quality of life. In recent years, significant progress has profoundly changed the management of IBD. It has recently been shown that changes in therapeutic strategies over the past few decades have changed the natural history of IBD. Nevertheless, the disease continues to have a negative impact on the quality of life of patients and the rates of complications, surgery, hospitalization or even exposure to corticosteroids remain high. Therefore, considering the progressive enrichment of therapeutic armament, the emergence of new monitoring strategies and new therapeutic objectives, this Special Issue will consider the emerging management strategies in both CD and UC. Through original research and reviews, this Special Issue aims to highlight the recent advances in the management of these diseases, from diagnosis to treatment, including non-invasive techniques for disease assessment, the emergence of new medical or surgical therapeutic strategies and their impact on disease natural history. Articles that address the challenges and opportunities to improve outcomes are also welcome.

Prof. Dr. Mathurin Fumery
Prof. Dr. Anthony Buisson
Guest Editors

Manuscript Submission Information

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Keywords

  • Crohn’s disease
  • diagnosis
  • monitoring
  • biomarkers
  • treatment

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Published Papers (6 papers)

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16 pages, 4742 KiB  
Article
Quantitative Phase Imaging Using Digital Holographic Microscopy to Assess the Degree of Intestinal Inflammation in Patients with Ulcerative Colitis
by Arne Bokemeyer, Joost Buskermolen, Steffi Ketelhut, Phil-Robin Tepasse, Richard Vollenberg, Jonel Trebicka, Hartmut H. Schmidt, Michael Vieth, Dominik Bettenworth and Björn Kemper
J. Clin. Med. 2023, 12(12), 4067; https://doi.org/10.3390/jcm12124067 - 15 Jun 2023
Cited by 8 | Viewed by 1711
Abstract
Ulcerative colitis (UC) is characterized by chronic inflammation of the colorectum. Histological remission has emerged as a potential future treatment goal; however, the histopathological assessment of intestinal inflammation in UC remains challenging with a multitude of available scoring systems and the need for [...] Read more.
Ulcerative colitis (UC) is characterized by chronic inflammation of the colorectum. Histological remission has emerged as a potential future treatment goal; however, the histopathological assessment of intestinal inflammation in UC remains challenging with a multitude of available scoring systems and the need for a pathologist with expertise in inflammatory bowel disease (IBD). In previous studies, quantitative phase imaging (QPI) including digital holographic microscopy (DHM) was successfully applied as an objective method for stain-free quantification of the degree of inflammation in tissue sections. Here, we evaluated the application of DHM for the quantitative assessment of histopathological inflammation in patients with UC. In our study, endoscopically obtained colonic and rectal mucosal biopsy samples from 21 patients with UC were analyzed by capturing DHM-based QPI images that were subsequently evaluated using the subepithelial refractive index (RI). The retrieved RI data were correlated with established histological scoring systems including the Nancy index (NI) as well as with endoscopic and clinical findings. As a primary endpoint, we found a significant correlation between the DHM-based retrieved RI and the NI (R2 = 0.251, p < 0.001). Furthermore, RI values correlated with the Mayo endoscopic subscore (MES; R2 = 0.176, p < 0.001). An area under the receiver operating characteristics (ROC) curve of 0.820 confirms the subepithelial RI as a reliable parameter to distinguish biopsies with histologically active UC from biopsies without evidence of active disease as determined by conventional histopathological examination. An RI higher than 1.3488 was found to be the most sensitive and specific cut-off value to identify histologically active UC (sensitivity of 84% and specificity of 72%). In conclusion, our data demonstrate DHM to be a reliable tool for the quantitative assessment of mucosal inflammation in patients with UC. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
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9 pages, 713 KiB  
Article
Comparison of the Persistence of Anti-TNF Agents and Ustekinumab in Patients with Crohn’s Disease: A Study Based on the Korean National Database
by Gi Hyeon Seo and Sung Hoon Jung
J. Clin. Med. 2023, 12(6), 2397; https://doi.org/10.3390/jcm12062397 - 20 Mar 2023
Cited by 3 | Viewed by 1998
Abstract
Background: Biologics play an important role in the treatment of moderate to severe Crohn’s disease (CD). Ustekinumab was approved for such patients in the Republic of Korea on 1 December 2018. Therefore, we need to compare the efficacy of ustekinumab and anti-TNF inhibitors. [...] Read more.
Background: Biologics play an important role in the treatment of moderate to severe Crohn’s disease (CD). Ustekinumab was approved for such patients in the Republic of Korea on 1 December 2018. Therefore, we need to compare the efficacy of ustekinumab and anti-TNF inhibitors. Methods: We compared one-year persistence rates between anti-TNF inhibitors and ustekinumab in moderate-to-severe CD patients using Korean National Health Insurance Service data from 1 December 2016 to 30 November 2021. We also analysed the risk factors for the non-persistence of biologics. Results: The one-year persistence rates with index therapy in bio-naïve and bio-experienced patients were 87.7% and 69.7% for infliximab (p < 0.001), 85.1% and 72.8% for adalimumab (p < 0.001), and 92.1% and 89.8% for ustekinumab (p = 0.333), respectively. The risk factors for non-persistence were older age, non-use of an immune modulator, and previous biologic exposure in both the infliximab and adalimumab groups. The one-year persistence rate of ustekinumab was higher than that of anti-TNF inhibitors in bio-naïve patients (hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.35–0.81; p = 0.003) and bio-experienced patients (HR 0.32; 95% CI 0.22–0.45; p < 0.001). Conclusions: Ustekinumab was superior in bio-naïve CD patients compared to anti-TNF inhibitors. However, the follow-up time was relatively short; further studies should continuously collect and analyse data. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
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12 pages, 266 KiB  
Article
Insights into Mesalazine Use in Clinical Practice of Young Gastroenterologists
by Olga Maria Nardone, Giovanni Marasco, Loris Riccardo Lopetuso, Giammarco Mocci, Luca Pastorelli, Carlo Petruzzellis, Franco Scaldaferri and on behalf of the Italian Association of Young Gastroenterologist and Endoscopist (AGGEI)
J. Clin. Med. 2023, 12(5), 2005; https://doi.org/10.3390/jcm12052005 - 2 Mar 2023
Cited by 3 | Viewed by 2026
Abstract
Background: Mesalazine is among the medications most prescribed by gastroenterologists, with variable and controversial use in different settings. We aimed to explore the use of mesalazine in the clinical practice of young gastroenterologists. Methods: A web-based electronic survey was distributed to all participants [...] Read more.
Background: Mesalazine is among the medications most prescribed by gastroenterologists, with variable and controversial use in different settings. We aimed to explore the use of mesalazine in the clinical practice of young gastroenterologists. Methods: A web-based electronic survey was distributed to all participants of the National Meeting of the Italian Young Gastroenterologist and Endoscopist Association. Results: A total of 101 participants took part in the survey, with a majority (54.4%) being aged >30 years, 63.4% of whom were trainees in academic hospitals, and 69.3% of whom were involved in the clinical management of inflammatory bowel disease (IBD). While both non-dedicated and IBD physicians generally agreed on the appropriate dose of mesalazine for mild ulcerative colitis (UC), significant differences were observed between the two groups for moderate-severe ulcerative colitis (UC). Additionally, in IBD patients who were starting immuno-modulators and/or biologics, 80% of IBD-dedicated physicians continued to prescribe mesalazine, compared to 45.2% of non-dedicated physicians (p = 0.002). Indeed, 48.4% of non-dedicated IBD physicians did not acknowledge mesalazine for colorectal cancer chemoprevention. With regards to Crohn’s disease, it is mainly used by 30.1% of IBD physicians for preventing postoperative recurrence of Crohn’s disease. Finally, 57.4% used mesalazine for symptomatic uncomplicated diverticular disease, and 84.2% did not recommend its use for irritable bowel syndrome. Conclusions: This survey showed heterogeneous behaviors in the daily use of mesalazine, mainly in the management of IBD. Educational programs and novel studies are needed to clarify its use. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
14 pages, 619 KiB  
Article
Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)
by Yamile Zabana, Ignacio Marín-Jiménez, Iago Rodríguez-Lago, Isabel Vera, María Dolores Martín-Arranz, Iván Guerra, Javier P. Gisbert, Francisco Mesonero, Olga Benítez, Carlos Taxonera, Ángel Ponferrada-Díaz, Marta Piqueras, Alfredo J. Lucendo, Berta Caballol, Míriam Mañosa, Pilar Martínez-Montiel, Maia Bosca-Watts, Jordi Gordillo, Luis Bujanda, Noemí Manceñido, Teresa Martínez-Pérez, Alicia López, Cristina Rodríguez-Gutiérrez, Santiago García-López, Pablo Vega, Montserrat Rivero, Luigi Melcarne, María Calvo, Marisa Iborra, Manuel Barreiro de Acosta, Beatriz Sicilia, Jesús Barrio, José Lázaro Pérez Calle, David Busquets, Isabel Pérez-Martínez, Mercè Navarro-Llavat, Vicent Hernández, Federico Argüelles-Arias, Fernando Ramírez Esteso, Susana Meijide, Laura Ramos, Fernando Gomollón, Fernando Muñoz, Gerard Suris, Jone Ortiz de Zarate, José María Huguet, Jordina Llaó, Mariana Fe García-Sepulcre, Mónica Sierra, Miguel Durà, Sandra Estrecha, Ana Fuentes Coronel, Esther Hinojosa, Lorenzo Olivan, Eva Iglesias, Ana Gutiérrez, Pilar Varela, Núria Rull, Pau Gilabert, Alejandro Hernández-Camba, Alicia Brotons, Daniel Ginard, Eva Sesé, Daniel Carpio, Montserrat Aceituno, José Luis Cabriada, Yago González-Lama, Laura Jiménez, María Chaparro, Antonio López-San Román, Cristina Alba, Rocío Plaza-Santos, Raquel Mena, Sonsoles Tamarit-Sebastián, Elena Ricart, Margalida Calafat, Sonsoles Olivares, Pablo Navarro, Federico Bertoletti, Horacio Alonso-Galán, Ramón Pajares, Pablo Olcina, Pamela Manzano, Eugeni Domènech, Maria Esteve and on behalf of the ENEIDA Registry of GETECCUadd Show full author list remove Hide full author list
J. Clin. Med. 2022, 11(24), 7540; https://doi.org/10.3390/jcm11247540 - 19 Dec 2022
Cited by 3 | Viewed by 3315
Abstract
(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide [...] Read more.
(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case–control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March–July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3–5.9), occupational risk (OR: 2.9; 95%CI: 1.8–4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2–2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09–0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
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12 pages, 991 KiB  
Article
Evaluation of Fecal Calprotectin, Serum C-Reactive Protein, Erythrocyte Sedimentation Rate, Seromucoid and Procalcitonin in the Diagnostics and Monitoring of Crohn’s Disease in Children
by Katarzyna Akutko and Barbara Iwańczak
J. Clin. Med. 2022, 11(20), 6086; https://doi.org/10.3390/jcm11206086 - 15 Oct 2022
Cited by 2 | Viewed by 2004
Abstract
Background: The development of diagnostic and monitoring algorithms for Crohn’s disease based on non-invasive methods is of particular importance in children and is the subject of many studies. Objectives: Evaluate the usefulness of fecal calprotectin, serum C-reactive protein, erythrocyte sedimentation rate, seromucoid and [...] Read more.
Background: The development of diagnostic and monitoring algorithms for Crohn’s disease based on non-invasive methods is of particular importance in children and is the subject of many studies. Objectives: Evaluate the usefulness of fecal calprotectin, serum C-reactive protein, erythrocyte sedimentation rate, seromucoid and procalcitonin in the differential diagnosis of non-inflammatory gastrointestinal tract diseases and Crohn’s disease in children and their usefulness in determining the phenotype of Crohn’s disease. Material and methods: Forty-seven children with non-inflammatory gastrointestinal tract diseases and fifty-four with Crohn’s disease were enrolled. Clinical and endoscopic activity was evaluated based on the Pediatric Crohn’s Disease Activity Index (PCDAI) and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Results: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid were significantly higher in children with Crohn’s disease than in controls (p < 0.001). Fecal calprotectin correlated with clinical and endoscopic activity according to the Pediatric Crohn’s Disease Activity Index (r = 0.338; p = 0.012) and the Simple Endoscopic Score for Crohn’s Disease (r = 0.428; p = 0.001). Non-invasive biomarkers did not correlate with the location and clinical manifestation of Crohn’s disease. Conclusions: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid are useful in the differentiation of Crohn’s disease from non-inflammatory gastrointestinal tract diseases in children and in monitoring the clinical course of Crohn’s disease, but not in evaluating activity and phenotype of the disease. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
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7 pages, 952 KiB  
Brief Report
Challenges of 3D Surface Reconstruction in Capsule Endoscopy
by Olivier Rukundo
J. Clin. Med. 2023, 12(15), 4955; https://doi.org/10.3390/jcm12154955 - 27 Jul 2023
Cited by 3 | Viewed by 2009
Abstract
Essential for improving the accuracy and reliability of bowel cancer screening, three-dimensional (3D) surface reconstruction using capsule endoscopy (CE) images remains challenging due to CE hardware and software limitations. This report generally focuses on challenges associated with 3D visualization and specifically investigates the [...] Read more.
Essential for improving the accuracy and reliability of bowel cancer screening, three-dimensional (3D) surface reconstruction using capsule endoscopy (CE) images remains challenging due to CE hardware and software limitations. This report generally focuses on challenges associated with 3D visualization and specifically investigates the impact of the indeterminate selection of the angle of the line–of–sight on 3D surfaces. Furthermore, it demonstrates that impact through 3D surfaces viewed at the same azimuth angles and different elevation angles of the line–of–sight. The report concludes that 3D printing of reconstructed 3D surfaces can potentially overcome line–of–sight indeterminate selection and 2D screen visual restriction-related errors. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory Bowel Diseases: From Diagnosis to Treatment)
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