Inflammatory Bowel Disease (IBD): Mechanism to Management

Topic Information

Dear Colleagues,

Inflammatory bowel diseases (IBD), mainly represented by ulcerative colitis (UC) and Crohn’s disease (CD), have always represented a challenge for clinicians, surgeons and scientists.

Many efforts have been made in order to define the pathogenesis of the disease and to establish the best conservative and surgical treatment options. The advancement of molecular and clinical research plays a role in our understanding of IBD. The etiology is still unclear, but genetic, immunological, and environmental factors seem to be involved in the pathogenesis of the disease.

Recent advances have a substantial impact on the therapeutic paradigm: to date, the aim of medical treatment is not only to control and face symptoms, but to decrease inflammation, to induce mucosal healing and alter the natural course of the disease. Early surgery is gradually gaining a more important role in the multidisciplinary management of IBD, rather than being only a last resort therapy. Tailored surgical approaches are proven to be a good alternative in terms of effectiveness, quality of life and costs as first-line therapy or as part of combination therapy with biologicals for certain conditions. The particular course of the IBDs dictates, when necessary, a surgical treatment by dedicated surgeons. As well, the indication for surgery should be discussed in a multidisciplinary team.  Moreover, even given the benign nature of this condition, the possible evolution of a malignant disease always has to be considered, for both the indication of surgery and the type of surgery to perform. Another key point of the IBD is the wide possibility of available surgical procedures to treat this condition, although this is difficult to standardize, and there is a high postoperative complication rate reported in literature.

This Special Issue offers an overview of the most recent advancements in the management of these patients.

Dr. Andrea Balla
Dr. Rosa Scaramuzzo
Dr. Anna Guida
Dr. Federica Saraceno
Topic Editors

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Life life	3.2	4.3	2011	17.8 Days	CHF 2600
Gastroenterology Insights gastroent	1.5	2.8	2009	34 Days	CHF 1600
Surgeries surgeries	-	0.8	2020	21.8 Days	CHF 1200

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Published Papers (4 papers)

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All Life Gastroenterology Insights Surgeries

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11 pages, 741 KiB  

Open AccessFeature PaperArticle

Body Composition as a Modulator of Bone Health Changes in Patients with Inflammatory Bowel Disease

by Iulia Soare, Anca Sirbu, Miruna Popa, Sorina Martin, Cristian George Tieranu, Bogdan Mateescu, Mircea Diculescu, Carmen Barbu and Simona Fica

Life 2022, 12(2), 272; https://doi.org/10.3390/life12020272 - 12 Feb 2022

Cited by 2 | Viewed by 2062

Abstract

Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body [...] Read more.

Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body composition and bone parameters in IBD patients. Methods: This is a cross-sectional, retrospective study including 80 IBD patients (43 women, 37 men). Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT). Trabecular bone score (TBS) was assessed using iNsight Software. Results: Twenty (25%) IBD patients had inadequate LS-BMD z scores (<=−2DS). Lean mass (LM) was a significant determinant of LS-BMD, after adjusting for age, gender, BMI and fat mass (p < 0.01), while fat mass% remained associated with FN-BMD (p < 0.01). TBS correlated positively with BMI (r = 0.24, p < 0.05), LS-BMD (r = 0.56, p < 0.001), ASMI (r = 0.34, p < 0.001) and negatively with VAT/total fat% (r = −0.27, p < 0.05). Multivariate analysis showed that ASMI, LS-BMD (positively) and VAT/total fat% (negatively) were independently associated with TBS. Conclusions: In IBD patients, skeletal muscle mass and fat percentage and distribution are important factors associated with bone health. Full article

(This article belongs to the Topic Inflammatory Bowel Disease (IBD): Mechanism to Management)

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10 pages, 267 KiB  

Open AccessArticle

Changes in Salivary Parameters of Oral Immunity after Biologic Therapy for Inflammatory Bowel Disease

by Kacper Nijakowski, Rafał Rutkowski, Piotr Eder, Katarzyna Korybalska, Janusz Witowski and Anna Surdacka

Life 2021, 11(12), 1409; https://doi.org/10.3390/life11121409 - 16 Dec 2021

Cited by 17 | Viewed by 2642

Abstract

We previously observed that inflammatory bowel disease (IBD) may compromise oral host defense, as assessed by decreased salivary levels of immunoglobulin A (IgA) and myeloperoxidase (MPO). Biologic therapy with inhibitors of cytokines or adhesion molecules is increasingly used for patients with IBD. Little [...] Read more.

We previously observed that inflammatory bowel disease (IBD) may compromise oral host defense, as assessed by decreased salivary levels of immunoglobulin A (IgA) and myeloperoxidase (MPO). Biologic therapy with inhibitors of cytokines or adhesion molecules is increasingly used for patients with IBD. Little is known, however, about how this treatment modality affects the release and properties of saliva. Here, we aimed to determine how biologic therapy in patients who had not responded to previous standard treatment with conventional drugs affected the salivary concentration of IgA and MPO. To this end, unstimulated whole mixed saliva was collected before treatment or after 10–12 weeks of therapy from 27 patients with Crohn’s disease (CD) and 24 patients with ulcerative colitis (UC). After the induction phase of therapy with biologics, salivary levels of IgA and MPO increased significantly in UC, but not in CD patients. These increases were approximately 8-fold and 6-fold, for IgA and MPO, respectively. Moreover, these effects occurred in UC patients who responded successfully to therapy, but not in those who failed to improve. Furthermore, the relative increases in salivary IgA and MPO correlated with the relative decrease in UC severity, as assessed by the Mayo scale. These data indicate that the successful therapy with biologics in UC patients results also in improved oral host defense. However, it remains to be determined why such an effect does not occur during therapy for CD. Full article

(This article belongs to the Topic Inflammatory Bowel Disease (IBD): Mechanism to Management)

8 pages, 630 KiB  

Open AccessArticle

Anemia in Newly Diagnosed Pediatric Patients with Inflammatory Bowel Disease

by Rayna Shentova-Eneva, Denitza Kofinova, Petyo Hadzhiyski, Penka Yaneva, Elena Lazarova and Mila Baycheva

Gastroenterol. Insights 2021, 12(4), 376-383; https://doi.org/10.3390/gastroent12040036 - 24 Sep 2021

Cited by 2 | Viewed by 3504

Abstract

Anemia is the most common extraintestinal manifestation and complication of inflammatory bowel disease (IBD). The aim of our study was to assess the prevalence of anemia in newly diagnosed pediatric patients with IBD and to analyze its association with disease type, extent, and [...] Read more.

Anemia is the most common extraintestinal manifestation and complication of inflammatory bowel disease (IBD). The aim of our study was to assess the prevalence of anemia in newly diagnosed pediatric patients with IBD and to analyze its association with disease type, extent, and severity. We retrospectively reviewed the medical records of all patients with IBD treated in our department in the period of November 2011 to November 2020. The final analysis included the records of 80 children with newly diagnosed IBD: 45 with ulcerative colitis (UC) and 35 with Crohn’s disease (CD). The prevalence of anemia was 60.0% in the UC patients and 77.1% in the CD patients. Of the UC patients with anemia, 37.1% had pancolitis, 18.5% extensive disease, 33.3% left-sided colitis and 11.1% ulcerative proctitis. Of the CD patients with anemia, 81.5% had ileocolonic disease, 11.1% colonic disease and 7.4% ileal disease. Anemia was less common in patients with mild disease than in patients with moderate–severe disease (22.2 vs. 77.8%, p < 0.001 in UC and 25.9% vs. 74.1%, p < 0.001 in CD). Our study confirmed anemia as a frequent problem in pediatric patients with IBD. Children with more extensive and more severe disease are at higher risk to develop anemia. Full article

(This article belongs to the Topic Inflammatory Bowel Disease (IBD): Mechanism to Management)

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9 pages, 291 KiB  

Open AccessCommentary

Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

by Richard H. Parrish II

Gastroenterol. Insights 2021, 12(3), 293-301; https://doi.org/10.3390/gastroent12030026 - 24 Jun 2021

Cited by 1 | Viewed by 4700

Abstract

This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic [...] Read more.

This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic mechanisms for inflammatory bowel diseases (IBD) in adult and pediatric patients. Since they are not identical to the originator or reference biologic agent, all biosimilars are not generically equivalent. However, in the US and other countries, they are considered therapeutically interchangeable if the manufacturer has demonstrated no clinically meaningful differences from the reference product. Comparisons of different clinical initiation and switching scenarios are discussed with reference to interchangeability, immunogenicity, nocebo effect, cost effectiveness, and time courses for discontinuation rates. Full article

(This article belongs to the Topic Inflammatory Bowel Disease (IBD): Mechanism to Management)

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