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Inflammatory Bowel Diseases
Efficacy and safety of vedolizumab in Crohn’s disease in patients from Asian countries in the GEMINI 2 study
Rupa Banerjee, Sai Wei Chuah, Ida Normiha Hilmi, Deng-Chyang Wu, Suk-Kyun Yang, Dirk Demuth, Dirk Lindner, Shashi Adsul
Intest Res 2021;19(1):83-94.   Published online December 31, 2020
DOI: https://doi.org/10.5217/ir.2019.09160
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The efficacy and safety of vedolizumab in moderate-to-severely active Crohn’s disease (CD) were demonstrated in the GEMINI 2 study (NCT00783692). This post-hoc exploratory analysis aimed to assess the efficacy and safety of vedolizumab in the subgroup of patients from Asian countries.
Methods
During the induction phase (doses at day 1, 15), clinical remission, enhanced clinical response, and change in C-reactive protein at 6 weeks; during the maintenance phase, clinical remission, enhanced clinical response, glucocorticoid-free remission and durable clinical remission at 52 weeks, were the efficacy outcomes of interest. Efficacy and safety of vedolizumab compared to placebo were assessed in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) using descriptive analyses.
Results
During the induction phase, in Asian countries (n = 51), 14.7% of the vedolizumab-treated patients achieved clinical remission at week 6 compared to none with placebo (difference, 14.7%; 95% confidence interval, 15.8%–43.5%). In non-Asian countries (n = 317), the remission rate at week 6 with vedolizumab was 14.5%. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 4 weeks, vedolizumab administered every 8 weeks and placebo were 41.7%, 36.4%, and 0%, respectively; while enhanced clinical response rates were 41.7%, 63.6%, and 42.9%, respectively. During induction, 39.7% of patients with vedolizumab experienced an adverse event compared to 58.8% of patients with placebo, and vedolizumab was generally well-tolerated.
Conclusions
This post-hoc analysis demonstrates the treatment effect and safety of vedolizumab in moderateto-severely active CD in patients from Asian countries.

Citations

Citations to this article as recorded by  
  • Comparative efficacy and safety of subcutaneous infliximab and vedolizumab in patients with Crohn’s disease and ulcerative colitis included in randomised controlled trials
    Laurent Peyrin‐Biroulet, Perttu Arkkila, Alessandro Armuzzi, Silvio Danese, Marc Ferrante, Jordi Guardiola, Jørgen Jahnsen, Edouard Louis, Milan Lukáš, Walter Reinisch, Xavier Roblin, Philip J Smith, Taek Kwon, Jeeyoung Kim, Sangwook Yoon, Dong-Hyeon Kim
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • A Review on Nanosystem-Based Delivery of Tofacitinib for Enhanced Treatment of Autoimmune Diseases and Inflammation
    Thi-Thao-Linh Nguyen, Van-An Duong
    BioNanoScience.2024; 14(2): 2048.     CrossRef
  • Application of clinical decision support tools for predicting outcomes with vedolizumab therapy in patients with inflammatory bowel disease: A KASID multicentre study
    Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun‐Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk‐Kyun Yang, Byong Duk Ye
    Alimentary Pharmacology & Therapeutics.2024; 59(12): 1539.     CrossRef
  • The treatment of inflammatory bowel disease with monoclonal antibodies in Asia
    Yu Chen, Guolin Zhang, Yuewen Yang, Shuangshuang Zhang, Haozheng Jiang, Kang Tian, Arenbaoligao, Dapeng Chen
    Biomedicine & Pharmacotherapy.2023; 157: 114081.     CrossRef
  • Real-World Evidence of Effectiveness and Safety of Vedolizumab for Inflammatory Bowel Disease in Taiwan: A Prospective Nationwide Registry (VIOLET) Study
    Wei-Chen Lin, Wei-Chen Tai, Chung-Hsin Chang, Chia-Hung Tu, I-Che Feng, Ming-Jium Shieh, Chen-Shuan Chung, Hsu-Heng Yen, Jen-Wei Chou, Jau-Min Wong, Yu-Hwa Liu, Tien-Yu Huang, Chiao-Hsiung Chuang, Tzung-Jiun Tsai, Feng-Fan Chiang, Chien-Yu Lu, Wen-Hung Hs
    Inflammatory Bowel Diseases.2023; 29(11): 1730.     CrossRef
  • Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study
    Joo Kyung Kim, Jae Hee Cheon
    Journal of Yeungnam Medical Science.2023; 40(1): 37.     CrossRef
  • Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
    Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim
    Intestinal Research.2023; 21(2): 244.     CrossRef
  • The Risk of Tuberculosis in Patients With Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab in Korea
    Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis
    Laurent Peyrin-Biroulet, Perttu Arkkila, Alessandro Armuzzi, Silvio Danese, Jordi Guardiola, Jørgen Jahnsen, Charles Lees, Edouard Louis, Milan Lukáš, Walter Reinisch, Xavier Roblin, Minyoung Jang, Han Geul Byun, Dong-Hyeon Kim, Sung Jeong Lee, Raja Atrey
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Personalized medicine in inflammatory bowel disease: Perspectives on Asia
    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
  • Prevention of postoperative recurrence in Crohn’s disease: the never-ending story
    Jung-Bin Park, Sang Hyoung Park
    Intestinal Research.2022; 20(3): 279.     CrossRef
  • Viral Hepatitis in Patients with Inflammatory Bowel Disease
    Seung Hwan Shin, Sang Hyoung Park
    The Korean Journal of Gastroenterology.2022; 80(2): 51.     CrossRef
  • Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
    Soo-Young Na, You Sun Kim
    The Korean Journal of Internal Medicine.2022; 37(5): 906.     CrossRef
  • Natural history of inflammatory bowel disease: a comparison between the East and the West
    Eun Mi Song, Suk-Kyun Yang
    Intestinal Research.2022; 20(4): 418.     CrossRef
  • Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies
    Hyo Yeop Song, Geom Seog Seo
    Journal of the Korean Medical Association.2021; 64(9): 605.     CrossRef
  • Current status of inflammatory bowel diseases in Korea
    Suk-Kyun Yang
    Journal of the Korean Medical Association.2021; 64(9): 572.     CrossRef
  • 7,977 View
  • 171 Download
  • 16 Web of Science
  • 16 Crossref
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Inflammatory Bowel Diseases
Efficacy and safety of vedolizumab in ulcerative colitis in patients from Asian countries in the GEMINI 1 study
Choon Jin Ooi, Ida Normiha Hilmi, Hyo-Jong Kim, Umesh Jalihal, Deng-Chyang Wu, Dirk Demuth, Dirk Lindner, Shashi Adsul
Intest Res 2021;19(1):71-82.   Published online September 4, 2020
DOI: https://doi.org/10.5217/ir.2019.09159
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The efficacy and safety of vedolizumab in moderate to severely active ulcerative colitis (UC) have been demonstrated in the GEMINI 1 study (NCT00783718). This post-hoc exploratory analysis sought to establish the efficacy and safety of vedolizumab in a subgroup of patients from Asian countries with UC from GEMINI 1.
Methods
Efficacy outcomes of interest were clinical response, clinical remission and mucosal healing at week 6 (induction phase); and clinical remission, durable clinical response, durable clinical remission, mucosal healing and glucocorticoid-free remission at week 52 (maintenance phase). Differences in outcome rates between vedolizumab and placebo in Asian countries (Hong Kong, India, Malaysia, Singapore, South Korea, and Taiwan) were assessed using descriptive analyses, and efficacy and safety compared between Asian and non-Asian countries.
Results
During induction, in Asian countries (n = 58), clinical response rates at week 6 with vedolizumab and placebo were 55.2% and 24.1%, respectively (difference 31.0%; 95% confidence interval: 7.2%–54.9%). In non-Asian countries (n = 316), response rates at week 6 with vedolizumab and placebo were 45.9% and 25.8%, respectively. During maintenance, in Asian countries, clinical remission rates at 52 weeks with vedolizumab administered every 8 weeks, vedolizumab administered every 4 weeks and placebo were 9.1%, 36.8%, and 31.6%, respectively; corresponding rates for mucosal healing were 45.5%, 47.4%, and 47.4%, respectively. Vedolizumab was well-tolerated; adverse event frequency was comparable in Asian and non-Asian countries.
Conclusions
In patients from Asian countries, the efficacy and safety of vedolizumab in treatment of UC were broadly consistent with that in the overall study population.

Citations

Citations to this article as recorded by  
  • Application of clinical decision support tools for predicting outcomes with vedolizumab therapy in patients with inflammatory bowel disease: A KASID multicentre study
    Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun‐Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk‐Kyun Yang, Byong Duk Ye
    Alimentary Pharmacology & Therapeutics.2024; 59(12): 1539.     CrossRef
  • Clinical performance of fecal calprotectin, lactoferrin, and hemoglobin for evaluating the disease activity of IBD and detecting colorectal tumors
    Tsukasa Yamakawa, Takakazu Miyake, Yoshihiro Yokoyama, Tomoe Kazama, Yuki Hayashi, Daisuke Hirayama, Shinji Yoshii, Hiro‐o Yamano, Satoshi Takahashi, Hiroshi Nakase
    JGH Open.2024;[Epub]     CrossRef
  • The role and prospect of tofacitinib in patients with ulcerative colitis
    Jun Lee
    Intestinal Research.2023; 21(1): 168.     CrossRef
  • The treatment of inflammatory bowel disease with monoclonal antibodies in Asia
    Yu Chen, Guolin Zhang, Yuewen Yang, Shuangshuang Zhang, Haozheng Jiang, Kang Tian, Arenbaoligao, Dapeng Chen
    Biomedicine & Pharmacotherapy.2023; 157: 114081.     CrossRef
  • Effectiveness and safety of vedolizumab for ulcerative colitis: a single-center retrospective real-world study in China
    Kaituo Huang, Jing Liu, Wenhao Xia, Chuwen Tian, Lingya Yao, Qian Cao, Haotian Chen
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • The effectiveness and safety of vedolizumab induction for moderate to severe ulcerative colitis for Asia patient: A real practice observational study
    Chia-Jung Kuo, Puo-Hsien Le, Wei-Chen Tai, Keng-Liang Wu, Hsu-Heng Yen, Chih-Wei Yen, Shui-Yi Tung, Chen-Shuan Chung, Ming-Yao Su, Cheng-Tang Chiu
    Journal of the Formosan Medical Association.2022; 121(9): 1689.     CrossRef
  • Vedolizumab does not increase perioperative surgical complications in patients with inflammatory bowel disease, cohort study
    Vitaliy Y. Poylin, Jose Cataneo Serrato, Jonathan Pastrana Del Valle, Joseph D. Feuerstein
    Intestinal Research.2022; 20(1): 72.     CrossRef
  • Comparative effectiveness of second-line biological therapies for ulcerative colitis and Crohn’s disease in patients with prior failure of anti-tumour necrosis factor treatment
    Hye Kyung Hyun, Hyun-Soo Zhang, Jongwook Yu, Eun Ae Kang, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • The Risk of Tuberculosis in Patients With Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab in Korea
    Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Personalized medicine in inflammatory bowel disease: Perspectives on Asia
    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
  • Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
    Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
    The Korean Journal of Internal Medicine.2022; 37(6): 1140.     CrossRef
  • Viral Hepatitis in Patients with Inflammatory Bowel Disease
    Seung Hwan Shin, Sang Hyoung Park
    The Korean Journal of Gastroenterology.2022; 80(2): 51.     CrossRef
  • Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
    Soo-Young Na, You Sun Kim
    The Korean Journal of Internal Medicine.2022; 37(5): 906.     CrossRef
  • Natural history of inflammatory bowel disease: a comparison between the East and the West
    Eun Mi Song, Suk-Kyun Yang
    Intestinal Research.2022; 20(4): 418.     CrossRef
  • Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies
    Hyo Yeop Song, Geom Seog Seo
    Journal of the Korean Medical Association.2021; 64(9): 605.     CrossRef
  • Combination of vedolizumab and immunomodulators in ulcerative colitis
    P Pinton
    Journal of Gastroenterology and Hepatology.2021; 36(12): 3556.     CrossRef
  • Adalimumab, Infliximab, and Vedolizumab in Treatment of Ulcerative Colitis: A Long-Term Retrospective Study in a Tertiary Referral Center
    Ann-Lorie Gagnon, William Beauchesne, Laurence Tessier, Charles David, Djamal Berbiche, Alexandre Lavoie, Alban Michaud-Herbst, Karine Tremblay
    Crohn's & Colitis 360.2021;[Epub]     CrossRef
  • Vedolizumab in Inflammatory Bowel Disease: West versus East
    Prasanta Debnath, Pravin M. Rathi
    Inflammatory Intestinal Diseases.2021; 6(1): 1.     CrossRef
  • 7,171 View
  • 253 Download
  • 17 Web of Science
  • 18 Crossref
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Inflammatory Bowel Diseases
The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis
Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park
Intest Res 2021;19(1):62-70.   Published online May 8, 2020
DOI: https://doi.org/10.5217/ir.2019.09156
AbstractAbstract PDFPubReaderePub
Background/Aims
Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can serve as biomarkers for diagnosing and assessing disease activity in ulcerative colitis (UC). We investigated their clinical significance in UC.
Methods
We analyzed 48 patients with UC who underwent measurement of fecal calprotectin (FC) and endoscopy and 96 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. The endoscopic activity was divided into 2 groups: group 1 (mild to moderate inflammation) and group 2 (severe inflammation) according to the Mayo endoscopic subscore in UC.
Results
To diagnose UC, the optimal cutoff of NLR and PLR was 2.26 (sensitivity 54.2%; specificity 90.6%; positive likelihood ratio 5.778, 95% confidence interval [CI] 2.944–11.339; area under the curve [AUC] 0.774, 95% CI, 0.690–0.859) and 179.8 (sensitivity 35.4%; specificity 90.6%; positive likelihood ratio 3.778, 95% CI 1.821–7.838; AUC 0.654, 95% CI 0.556–0.753), respectively. The optimal cutoff to differentiate group 1 and group 2 was 3.44, 175.9, and 453 µg/g for NLR, PLR, and FC, respectively (sensitivity, 63.6% vs. 90.9% vs. 81.8%; specificity, 81.1% vs. 78.4% vs. 73.0%; positive likelihood ratio, 3.364 vs. 4.205 vs. 3.027; AUC, 0.714 vs. 0.897 vs. 0.813). PLR had the highest AUC and positive likelihood ratio.
Conclusions
NLR and PLR help differentiate patients with UC from healthy controls. NLR, PLR, and FC indicate endoscopic activity and may reflect intestinal mucosal conditions.

Citations

Citations to this article as recorded by  
  • Predictive Value of Albumin to Fibrinogen Ratio and CALLY Index for Diagnosis of Ulcerative Colitis and Mucosal Healing After Vedolizumab Treatment
    Kairong Su, Sinan Xiao, Mei Wang, Kairuo Wang, Qing Fan, Sumei Sha, Yongli Cheng, Xin Liu, Haitao Shi
    Journal of Inflammation Research.2025; Volume 18: 589.     CrossRef
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  • Exploring the utility of cellular indices in the diagnosis of ulcerative colitis
    Julio César Moreno Alfonso, Sharom Barbosa-Velásquez, Carlos Delgado-Miguel, Ada Molina Caballero, Sara Hernández-Martín, Alberto Pérez Martínez, María Concepción Yárnoz Irazábal
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    Open Life Sciences.2025;[Epub]     CrossRef
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    Indian Journal of Dermatology.2022; 67(4): 477.     CrossRef
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  • Lymphocyte-to-Monocyte Ratio as a Marker for Endoscopic Activity in Ulcerative Colitis
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  • Peripheral blood neutrophil-to-lymphocyte ratio in inflammatory bowel disease and disease activity: A meta-analysis
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  • Association between platelet count and mucosal healing in Japanese patients with ulcerative colitis: a cross-sectional study
    Shinya Furukawa, Sen Yagi, Kana Shiraishi, Kenichirou Mori, Tomoyuki Ninomiya, Keitarou Kawasaki, Yuji Mizukami, Seiyuu Suzuki, Masayoshi Uraoka, Naozumi Shibata, Sanae Nakamura, Satoshi Imamine, Hidehiro Murakami, Katsuhisa Ohashi, Masamoto Torisu, Aki H
    BMC Gastroenterology.2020;[Epub]     CrossRef
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  • 233 Download
  • 28 Web of Science
  • 32 Crossref
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Inflammatory Bowel Diseases
Efficacy of biologic therapies for biologic-naïve Japanese patients with moderately to severely active ulcerative colitis: a network meta-analysis
Toshifumi Hibi, Isao Kamae, Philippe Pinton, Lyann Ursos, Ryuichi Iwakiri, Greg Hather, Haridarshan Patel
Intest Res 2021;19(1):53-61.   Published online April 22, 2020
DOI: https://doi.org/10.5217/ir.2019.09146
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Several biologic therapies are approved in Japan to treat moderately to severely active ulcerative colitis (UC), but there are no published comparative efficacy studies in a Japanese population. We compared the efficacy of biologics approved in Japan (adalimumab, infliximab, golimumab, and vedolizumab) for treating biologic-naïve patients with UC at their approved doses.
Methods
A targeted literature review identified 4 randomized controlled trials of biologics for UC in biologicnaïve Japanese patients. For each study, efficacy outcome data from induction (weeks 6–12) and maintenance (weeks 30–60) treatment were extracted for analysis. Treatment effects on clinical response, clinical remission, and mucosal healing relative to the average placebo results across all trials were estimated using network meta-analyses followed by transformation into probabilities and odds ratios (OR).
Results
At the end of induction, the likelihood of clinical response and clinical remission was highest with infliximab (OR: 2.12 and 2.35, respectively) and vedolizumab (OR: 2.10 and 2.32, respectively); the likelihood of mucosal healing was highest with infliximab (OR: 2.24) and adalimumab (OR: 1.86). During maintenance, the likelihood of clinical response and clinical remission was highest with vedolizumab (OR: 6.44 and 4.68, respectively) and golimumab (OR: 5.13 and 3.84, respectively); the likelihood of mucosal healing was significantly higher than placebo with all biologics.
Conclusions
All active treatments were efficacious compared with placebo. Infliximab and vedolizumab had the highest odds for induction of clinical response, remission, and mucosal healing. Golimumab and vedolizumab had numerically higher odds of achieving efficacy outcomes in the maintenance phase.

Citations

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  • Effectiveness of adalimumab in severe ulcerative colitis: A systematic review and a meta‐analysis
    Saleh Azadbakht, Masomeh Seighali, Salehe Azadbakht, Morteza Azadbakht
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    Takahiro Amano, Takeo Yoshihara, Shinichiro Shinzaki, Yuko Sakakibara, Takuya Yamada, Naoto Osugi, Satoshi Hiyama, Yoko Murayama, Koji Nagaike, Hideharu Ogiyama, Toshio Yamaguchi, Yuki Arimoto, Ichizo Kobayashi, Shoichiro Kawai, Satoshi Egawa, Takashi Kiz
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    Jun Lee
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    Soo-Young Na
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    Viviana Laredo, Carla J. Gargallo-Puyuelo, Fernando Gomollón
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    Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
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    Eun Ae Kang
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    Kyuwon Kim, Hee Seung Hong, Kyunghwan Oh, Jae Yong Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park
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    Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
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    Byung Chul Jin, Hee Jin Moon, Sang Wook Kim
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    Seung Hwan Shin, Sang Hyoung Park
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    Hyo Yeop Song, Geom Seog Seo
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    Jae Yong Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Ho-Su Lee, Kyung-Wook Jo, Sang Hyoung Park
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Inflammatory Bowel Diseases
Quality of life in inflammatory bowel diseases: it is not all about the bowel
Ronald Keller, Nazar Mazurak, Laura Fantasia, Stefano Fusco, Nisar P Malek, Jan Wehkamp, Paul Enck, Thomas Klag
Intest Res 2021;19(1):45-52.   Published online February 27, 2020
DOI: https://doi.org/10.5217/ir.2019.00135
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD) are chronic diseases mostly affecting young patients. As they are diseases accompanying patients for their entire life, and the quality of life (QUOL) interacts with disease activity, improving QUOL should be one of the main goals of therapy. This study aims to identify factors contributing to good or impaired QUOL.
Methods
Questionnaires addressing health-related QUOL and other psychological and social features were positioned on our institutions’ webpage and on the webpage of the largest self-help group for IBD in Germany. Patients were subdivided according to their QUOL score with a cutoff of <60. We used the Short Inflammatory Bowel Disease Questionnaire, the Assessment of the Demand for Additional Psychological Treatment, and the Fear of Progression Questionnaire Short Form.
Results
High numbers of patients in both subgroups showed an impaired QUOL (87.34% in UC, 91.08% in CD). Active extraintestinal manifestations, smoking, high fear of progression and high demand for psychotherapy were associated with reduced QUOL. In addition, polypharmacological interventions did not result in a good QUOL, but ostomies are linked to improved QUOL especially in CD patients.
Conclusions
Scores used in clinical day-to-day-practice mainly focusing on somatic factors do not sufficiently address important aspects concerning QUOL. Most importantly, extraintestinal manifestations show a hitherto underestimated impact on QUOL.

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Functional bowel disorders
Psychological profiles of irritable bowel syndrome patients with different phenotypes
Michel Bouchoucha, Ghislain Devroede, Noëlle Girault-Lidvan, Maria Hejnar, Florence Mary, Robert Benamouzig
Intest Res 2020;18(4):459-468.   Published online October 26, 2020
DOI: https://doi.org/10.5217/ir.2019.09171
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Abnormal psychological profiles are frequently found in patients with functional gastrointestinal disorders (FGIDs). The present study aimed to evaluate the psychological profiles of FGID patients with irritable bowel syndrome (IBS), and IBS phenotypes.
Methods
In 608 FGID patients, including 235 with IBS, have filled a Rome III questionnaire and the French version of the Minnesota Multiphasic Personality Inventory 2. Data analysis was performed using univariate analysis and multivariate logistic regression.
Results
This study shows that IBS patients have abnormal psychological profiles with more significant symptom exaggeration and decreased test defensiveness than non-IBS patients. They have a significantly higher score for all clinical scales. Logistic regression analysis showed in IBS patients a decrease of body mass index (P= 0.002), and test defensiveness score K (P= 0.001) and an increase of Hypochondriasis (P< 0.001) and Masculinity-Femininity scale (P= 0.018). By comparison with non-IBS patients, IBS-constipation, IBS-diarrhea, and mixed IBS patients have increased Hypochondriasis value and Depression score, mixed IBS patients have higher Psychasthenia score and higher Hypomania score. No item was significantly different in the IBS-unspecified group.
Conclusions
This study shows that IBS patients have different psychological profiles than other FGID patients and that psychological characteristics are associated with IBS phenotypes except for patients with unsubtyped IBS.

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    Paris A. Lang, Linda Thomas, Brett A. Lidbury
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Inflammatory bowel diseases
An assessment of dietary intake, food avoidance and food beliefs in patients with ulcerative colitis of different disease status
Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali
Intest Res 2020;18(4):447-458.   Published online June 2, 2020
DOI: https://doi.org/10.5217/ir.2019.00042
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Ulcerative colitis (UC) is a chronic, relapsing and remitting inflammation of the gastrointestinal tract. Little is known about the link between dietary intake, food avoidance, and beliefs among UC patients of different disease severity. Therefore, this study aimed to assess the dietary intake, food avoidance, and beliefs among active and inactive UC patients.
Methods
A cross-sectional study was conducted among UC patients from a tertiary medical center in Kuala Lumpur, Malaysia. Demographic, anthropometric, dietary intake, food avoidance and beliefs were assessed. Disease activity of UC patients was evaluated using the Powell Tuck Index.
Results
UC patients were recruited (64.1% inactive UC and 35.9% active UC). As compared to inactive UC patients, active UC patients were likely to lose weight (75.0% vs. 0%), possess certain food beliefs (95.7% vs. 39.0%), and frequently practiced dietary avoidance (95.7% vs. 43.9%). The dietary intake among inactive UC patients was higher than active UC patients. However, neither of them met the standard nutrients recommendation for protein, calcium, iron, folate, zinc, vitamin D, vitamin B12, and vitamin E.
Conclusions
Active UC patients had poorer dietary intake, were more prone to practicing food avoidance and exhibited certain food beliefs as compared to inactive UC patients. Both macro- and micronutrients intakes were inadequate regardless of patient’s disease status. These findings emphasized the importance for patients to be provided with the nutrition-related knowledge as part of strategies to avoid nutritional inadequacies.

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  • Addressing Nutritional Knowledge Gaps in Inflammatory Bowel Disease: A Scoping Review
    Eleonora Ribaudi, Simone Amato, Guia Becherucci, Sara Carillo, Carlo Covello, Vincenzina Mora, Maria Chiara Mentella, Franco Scaldaferri, Antonio Gasbarrini, Caterina Fanali, Lucrezia Laterza, Daniele Napolitano
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    Filippo Vernia, Emanuela Ribichini, Giorgia Burrelli Scotti, Giovanni Latella
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    Dominika Głąbska, Dominika Guzek, Gustaw Lech
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    Wenjing Tu, Shuxia Yan, Tingting Yin, Sumin Zhang, Wenjing Xu, Ping Zhang, Guihua Xu
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    Kathy Vagianos, Leigh Anne Shafer, Kelcie Witges, Lesley A. Graff, Laura E. Targownik, Charles N. Bernstein
    Journal of Parenteral and Enteral Nutrition.2022; 46(7): 1686.     CrossRef
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    Seung Hyuk Kim, You Sun Kim, Si Hyeong Lee, Hyun Mi Lee, Won Eui Yoon, Seo Hyun Kim, Hee Jun Myung, Jeong Seop Moon
    Intestinal Research.2022; 20(3): 321.     CrossRef
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    Cheng-Tzu Hsieh, Meng-Tzu Weng, Chien-Chih Tung, Nai-Chia Chen, Hui-Chuen Chen, Kuo-Liong Chien, Shu-Chen Wei
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    Amany Hussien, Sawsan Abd El-Moniem, Ziyad Tawhid, Ahmed Altonbary
    The Egyptian Journal of Internal Medicine.2022;[Epub]     CrossRef
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  • 154 Download
  • 8 Web of Science
  • 8 Crossref
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Inflammatory bowel diseases
Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease
Kyeong Ok Kim, Michael V. Chiorean
Intest Res 2020;18(4):438-446.   Published online October 26, 2020
DOI: https://doi.org/10.5217/ir.2019.00090
AbstractAbstract PDFPubReaderePub
Background/Aims
Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD.
Methods
Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.
Results
A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (P= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, P= 0.002) and serrated lesions (14.5% vs. 6.1%, P= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, P< 0.001). Cancer was diagnosed in 2 cases.
Conclusions
CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

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Inflammatory bowel diseases
Prevalence and patient awareness of inflammatory bowel disease in Kazakhstan: a cross-sectional study
Jamilya Kaibullayeva, Aliya Ualiyeva, Ainash Oshibayeva, Anar Dushpanova, John K. Marshall
Intest Res 2020;18(4):430-437.   Published online September 29, 2020
DOI: https://doi.org/10.5217/ir.2019.00099
AbstractAbstract PDFPubReaderePub
Background/Aims
There has been a paucity of published data on the epidemiology of inflammatory bowel disease (IBD) in Central Asia and Kazakhstan. Therefore, we aimed to study IBD prevalence and patient awareness among adults in Kazakhstan.
Methods
The cross-sectional study was carried out among subjects of both sexes aged 18 years and older using IBD Alert Questionnaire (CalproQuest), single fecal calprotectin test, and endoscopy with biopsy to verify IBD from January to December 2017, across regions of Kazakhstan. All participants were included in the study after providing informed consent.
Results
Out of 115,556 subjects, there were 128 confirmed IBD cases, in which 36 Crohn’s disease (CD) and 92 ulcerative colitis (UC) cases identified. The age and sex-adjusted IBD prevalence were 113.9 (95% confidence interval [CI], 69.0–158.9) per 100,000 population. The age- and sex-adjusted prevalence for UC were 84.4 (95% CI, 44.8–123.9) and for CD were 29.5 (95% CI, 8.2–50.9) per 100,000 population.
Conclusions
This is the first report on the prevalence of IBD with a verified diagnosis in the Central Asia and could be used to better plan and allocate healthcare resources for IBD management program.

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Inflammatory bowel diseases
Pathophysiological role of Atg5 in human ulcerative colitis
Razieh Ardali, Nasrin Kazemipour, Saeed Nazifi, Kamran Bagheri Lankarani, Iman Razeghian Jahromi, Masood Sepehrimanesh
Intest Res 2020;18(4):421-429.   Published online May 8, 2020
DOI: https://doi.org/10.5217/ir.2019.00120
AbstractAbstract PDFPubReaderePub
Background/Aims
Ulcerative colitis (UC), along with Crohn’s disease, is one of the main types of inflammatory bowel disease (IBD). On the other hand, deregulated autophagy is involved in many chronic diseases, including IBD. In this study, we aimed to investigate the role of Atg5 and microRNA-181a (miR-181a) in the pathophysiology of UC.
Methods
Colon biopsy, stool, and blood samples of 6 men and 9 women were confirmed for UC. Also, 13 men and 17 women were selected as healthy control (HC). Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to measure the Atg-5 content of the colon biopsies. Besides, the serum and stool levels of Atg5 were measured using ELISA. Moreover, the total RNA of blood cells was extracted and evaluated for the expression of miR-181a.
Results
We found 1.2 ng/mL versus 0.46 ng/mL, 0.34 ng/mL versus 0.24 ng/mL, and 0.082 ng/mL versus 0.062 ng/mL of Atg5 in stool, intestinal tissue, and serum of UC and HCs, respectively. There was no significant difference in the expression of miR-181a in the blood samples of UC and HCs. Immunohistochemistry showed high positivity without any significant difference between the 2 groups in the quantitative analysis.
Conclusions
The significant difference observed between the stool Atg5 content of the HCs and UC patients may provide new insight into using this protein as a diagnostic biomarker, however, considering the small size of our studied population further studies are needed.

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    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
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    Soo-Young Na, You Sun Kim
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    Dan Qiao, Ziwei Zhang, Yali Zhang, Qian Chen, Yujun Chen, Yingjue Tang, Xiong Sun, Zhipeng Tang, Yancheng Dai
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • 6,334 View
  • 134 Download
  • 9 Web of Science
  • 10 Crossref
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Inflammatory bowel diseases
Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry
Katsuhiro Arai, Reiko Kunisaki, Fumihiko Kakuta, Shin-ichiro Hagiwara, Takatsugu Murakoshi, Tadahiro Yanagi, Toshiaki Shimizu, Sawako Kato, Takashi Ishige, Tomoki Aomatsu, Mikihiro Inoue, Takeshi Saito, Itaru Iwama, Hisashi Kawashima, Hideki Kumagai, Hitoshi Tajiri, Naomi Iwata, Takahiro Mochizuki, Atsuko Noguchi, Toshihiko Kashiwabara, Hirotaka Shimizu, Yasuo Suzuki, Yuri Hirano, Takeo Fujiwara
Intest Res 2020;18(4):412-420.   Published online August 18, 2020
DOI: https://doi.org/10.5217/ir.2019.00130
AbstractAbstract PDFPubReaderePub
Background/Aims
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.

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Inflammatory bowel diseases
A glycolipid adjuvant, 7DW8-5, provides a protective effect against colonic inflammation in mice by the recruitment of CD1d-restricted natural killer T cells
Chansu Lee, Sung Noh Hong, Young-Ho Kim
Intest Res 2020;18(4):402-411.   Published online April 8, 2020
DOI: https://doi.org/10.5217/ir.2019.00132
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The modulation of CD1d-restricted natural killer T (NKT) cells by glycolipids has been considered as a potential therapy against immunologic diseases, including inflammatory bowel disease. A recently identified a glycolipid analog, 7DW8-5, which is derived from α-galactosylceramide (α-GalCer), is as much as 100-fold more active at stimulating both human and mice NKT cells when compared to α-GalCer. We explored the effects of 7DW8-5 in mouse models of acute and chronic colitis.
Methods
We investigated the effects of 7DW8-5 on intestinal inflammation by assessing the effects of 7dW8-5 on a murine dextran sulfate sodium (DSS)-induced acute colitis model and a chronic colitis-associated tumor model.
Results
The acute DSS-induced colitis model showed a dose-dependent response to 7DW8-5, as mice administered 7DW8-5 showed a significant improvement in DSS-induced colitis based on their disease activity index, histologic analysis, and serum C-reactive protein levels, when compared to mice administered vehicle alone. However, DSS-induced colitis in CD1d-KO mice showed no response to 7DW8-5. A fluorescence-activating cell sorting analysis revealed an increase in NKT cells in colonic tissues of 7DW8-5-treated mice. RNA-seq and real-time quantitative polymerase chain reaction showed a significant increase in the expression of interleukin (IL)-4, IL-13, and interferon-gamma in 7DW8-5-treated mice. In addition, 7DW8-5 treatment reduced colitis-associated tumor development in an azoxymethane/DSS mouse model.
Conclusions
7DW8-5 activates NKT cells through CD1d and provides a protective effect against intestinal inflammation in mice. Therefore, 7DW8-5 may be a promising therapeutic agent for treatment of inflammatory bowel disease.

Citations

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    Sung Won Lee, Hyun Jung Park, Luc Van Kaer, Seokmann Hong
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    Felicia N. Watson, Caroline J. Duncombe, Anya C. Kalata, Ethan Conrad, Sumana Chakravarty, B. Kim Lee Sim, Stephen L. Hoffman, Moriya Tsuji, Melanie J. Shears, Sean C. Murphy
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Miscellaneous
Melatonin in the colon modulates intestinal microbiota in response to stress and sleep deprivation
Young Sook Park, Soo Hyung Kim, Jong Won Park, Younglim Kho, Pu Rum Seok, Jae-Ho Shin, Yoon Ji Choi, Jin-Hyun Jun, Hee Chan Jung, Eun Kyung Kim
Intest Res 2020;18(3):325-336.   Published online June 23, 2020
DOI: https://doi.org/10.5217/ir.2019.00093
AbstractAbstract PDFPubReaderePub
Background/Aims
Stress is closely related to the deterioration of digestive disease. Melatonin has potent anti-inflammatory properties. The objective of this study was to determine the effect of water stress (WS) and sleep deprivation (SD) on intestinal microbiota and roles of melatonin in stressful condition.
Methods
We used C57BL/6 mice and specially designed water bath for stress and SD for 10 days. We measured melatonin concentrations in serum, feces, and colon tissues by high-performance liquid chromatography. Genomic DNA was extracted from feces and amplified using primers targeting V3 to V4 regions of bacterial 16S ribosomal RNA genes.
Results
Compared to the control, melatonin concentration was lower in the WS and SD. Fecal concentration was 0.132 pg/mL in control, 0.062 pg/mL in WS, and 0.068 pg/mL in SD. In colon tissue, it was 0.45 pg/mL in control, 0.007 pg/mL in WS, and 0.03 pg/mL in SD. After melatonin treatment, melatonin concentrations in feces and colon tissue were recovered to the level of control. Metagenomic analysis of microbiota showed abundance in colitogenic microbiota in WS and SD. Melatonin injection attenuated this harmful effect. WS and SD showed decreased Lactobacillales and increased Erysipelotrichales and Enterobacteriales. Melatonin treatment increased Akkermansia muciniphila and Lactobacillus and decreased Bacteroides massiliensis and Erysipelotrichaceae.
Conclusions
This study showed that stress and SD could affect intestinal dysbiosis and increase colitogenic microbiota, which could contribute to the aggravating digestive disease. Melatonin concentrations in feces and colon tissue decreased under WS and SD. Melatonin treatment brought recovery of melatonin concentration in colon tissue and modulating dysbiosis of intestinal microbiota.

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Colorectal neoplasia
Factors associated with the survival of colorectal cancer in Mexico
Carlos Quezada-Gutiérrez, María Teresa Álvarez-Bañuelos, Jaime Morales-Romero, Clara Luz Sampieri, Raúl Enrique Guzmán-García, Evangelina Montes-Villaseñor
Intest Res 2020;18(3):315-324.   Published online May 19, 2020
DOI: https://doi.org/10.5217/ir.2019.09179
AbstractAbstract PDFPubReaderePub
Background/Aims
Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment.
Methods
A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis.
Results
Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P= 0.026) and an advanced clinical stage of 22% (P< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (P= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1–54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2–4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1–2.9).
Conclusions
Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.

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    P.F Gomez- Galicia, I. Parola-Contreras, Juan Gabriel Báez- González, R. Durán-Lugo
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    Edvina Elena Pîrvu, Emilia Severin, Raluca Ileana Pătru, Irina Niță, Stefania Andreea Toma, Roxana Rodica Macarie, Cristina Elena Cocioabă, Ioana Florescu, Simona Coniac
    Diagnostics.2023; 13(18): 2930.     CrossRef
  • Immune profile by multiplexed immunohistochemistry associated with recurrence after chemoradiation in rectal cancer
    Seung Wook Hong, Seohyun Lee, Yun Jae Kim, Soyeon Ahn, In Ja Park, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jaeil Kim, Sang‐Yeob Kim, Seung‐Jae Myung
    Journal of Gastroenterology and Hepatology.2022; 37(3): 542.     CrossRef
  • Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study
    Suh Hyun Choi, Won Eui Yoon, Seung Hyuk Kim, Hee Jun Myung, Seo Hyun Kim, Soon Oh So, Se Hun Kim, Hyun Mi Lee, Yeoun Jung Oh, Jeong Seop Moon, Tae Yeong Park, You Sun Kim
    The Korean Journal of Gastroenterology.2022; 80(2): 85.     CrossRef
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    Ji Young Chang
    Clinical Endoscopy.2022; 55(5): 699.     CrossRef
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    Bruna Valiati, Rodrigo Oliva Perez, Paulo Gustavo Kotze
    Intestinal Research.2020; 18(3): 247.     CrossRef
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Inflammatory bowel diseases
Concordance between tuberculin skin test and interferon-gamma release assay for latent tuberculosis screening in inflammatory bowel disease
Saad Alrajhi, Pascale Germain, Myriam Martel, Peter Lakatos, Talat Bessissow, Talal Al-Taweel, Waqqas Afif
Intest Res 2020;18(3):306-314.   Published online March 20, 2020
DOI: https://doi.org/10.5217/ir.2019.00116
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Latent tuberculosis screening is mandatory prior to initiating anti-tumor necrosis factor (anti-TNF) medications. Guidelines recommend interferon-gamma release assays (IGRA) as first line screening method for the general population. Studies provided conflicting evidence on IGRA and tuberculin skin test (TST) performance in inflammatory bowel disease (IBD) patients. We assessed test concordance and the effects of immunosuppression on their performance in IBD patients.
Methods
We searched MEDLINE, Embase and Cochrane databases (2011–2018) for studies testing TST and IGRA in IBD. Primary outcome was TST and IGRA concordance. Secondary outcomes were effects of immunosuppressive therapy on performance. Immunosuppression defined as either steroids, thiopurine, methotrexate or cyclosporine use. We used the pooled random effects model to adjust for heterogeneity analyzed using (I2–Q statistics). We compared the fixed model to exclude smaller study effects.
Results
Sixteen studies (2,488 patients) were included. Pooled TST and IGRA concordance was 85% (95% confidence interval [CI], 81%–88%; P=0.01). Effects of immunosuppression were reported in 8 studies (814 patients). The odds ratio of testing positive by IGRA decreased to 0.57 if immunosuppressed (95% CI, 0.31–1.03; P=0.06). The odds ratio of testing positive by TST if immunosuppressed was 1.14 (95% CI, 0.61–2.12; P=0.69). The fixed model yielded similar results, however the negative effect of immunosuppression on IGRA reached statistical significance (P=0.01).
Conclusions
While concordance was 85% between TST and IGRA, the performance of IGRA seems to be negatively affected by immunosuppression. Given the importance of detecting latent tuberculosis prior to anti-TNF initiation, further randomized controlled trials comparing the performance of TST and IGRA in IBD patients are needed.

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    Priyanka, Parul Bhatt, Ayushi Kaur Bedi, Mandira Varma Basil, Monika Sharma, Sadhna Sharma
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  • Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
    Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
    Journal of Personalized Medicine.2022; 12(3): 507.     CrossRef
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    Myeong Geun Choi, Byong Duk Ye, Suk-Kyun Yang, Tae Sun Shim, Kyung-Wook Jo, Sang Hyoung Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Prophylactic Antitubercular Therapy Is Associated With Accelerated Disease Progression in Patients With Crohn's Disease Receiving Anti-TNF Therapy: A Retrospective Multicenter Study
    Fen Liu, Jian Tang, Lingna Ye, Jinyu Tan, Yun Qiu, Fan Hu, Jinshen He, Baili Chen, Yao He, Zhirong Zeng, Ren Mao, Qian Cao, Xiang Gao, Minhu Chen
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    Jihye Park, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2022; 37(5): 895.     CrossRef
  • Latent and Active Tuberculosis Infection in Patients with Inflammatory Bowel Disease
    Byung Chul Jin, Hee Jin Moon, Sang Wook Kim
    The Korean Journal of Gastroenterology.2022; 80(2): 72.     CrossRef
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    Seung Wook Hong, Sang Hyoung Park, Byong Duk Ye, Suk-Kyun Yang
    The Ewha Medical Journal.2021; 44(3): 93.     CrossRef
  • Risk and characteristics of tuberculosis after anti-tumor necrosis factor therapy for inflammatory bowel disease: a hospital-based cohort study from Korea
    Jae Yong Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Ho-Su Lee, Kyung-Wook Jo, Sang Hyoung Park
    BMC Gastroenterology.2021;[Epub]     CrossRef
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    Seong-Eun Kim
    The Ewha Medical Journal.2021; 44(4): 148.     CrossRef
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Inflammatory bowel diseases
Hypermethylated promoters of tumor suppressor genes were identified in Crohn’s disease patients
Tae-Oh Kim, Yu Kyeong Han, Joo Mi Yi
Intest Res 2020;18(3):297-305.   Published online February 7, 2020
DOI: https://doi.org/10.5217/ir.2019.00105
AbstractAbstract PDFPubReaderePub
Background/Aims
Overwhelming evidence suggests that inflammatory bowel disease (IBD) is caused by a complicated interplay between the multiple genes and abnormal epigenetic regulation in response to environmental factors. It is becoming apparent that epigenetic factors are significantly associated with the development of the disease. DNA methylation remains the most studied epigenetic modification, and hypermethylation of gene promoters is associated with gene silencing.
Methods
DNA methylation alterations may contribute to the many complex diseases development by regulating the interplay between external and internal environmental factors and gene transcriptional expression. In this study, we used 15 tumor suppressor genes (TSGs), originally identified in colon cancer, to detect promoter methylation in patients with Crohn’s disease (CD). Methylation specific polymerase chain reaction and bisulfite sequencing analyses were performed to assess methylation level of TSGs in CD patients.
Results
We found 6 TSGs (sFRP1, sFRP2, sFRP5, TFPI2, Sox17, and GATA4) are robustly hypermethylated in CD patient samples. Bisulfite sequencing analysis confirmed the methylation levels of the sFRP1, sFRP2, sFRP5, TFPI2, Sox17, and GATA4 promoters in the representative CD patient samples.
Conclusions
In this study, the promoter hypermethylation of the TSGs observed indicates that CD exhibits specific DNA methylation signatures with potential clinical applications for the noninvasive diagnosis of IBD and the prognosis for patients with IBD.

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  • Effects of DNA methylation and its application in inflammatory bowel disease (Review)
    Francis Akanyibah, Yi Zhu, Aijun Wan, Dickson Ocansey, Yuxuan Xia, An-Ning Fang, Fei Mao
    International Journal of Molecular Medicine.2024;[Epub]     CrossRef
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    Davide Guido, Fatima Maqoud, Michelangelo Aloisio, Domenica Mallardi, Blendi Ura, Nicolò Gualandi, Massimiliano Cocca, Francesco Russo
    International Journal of Molecular Sciences.2024; 25(17): 9322.     CrossRef
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    Ehsan Gharib, Gilles A. Robichaud
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    Raquel Francés, Yuanji Fu, Christophe Desterke, Jorge Mata-Garrido
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    Farzaneh Kefayati, Atoosa Karimi Babaahmadi, Taraneh Mousavi, Mahshid Hodjat, Mohammad Abdollahi
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    Zhongxin Wang, Jian Shang, Guannan Zhang, Lingjun Kong, Feng Zhang, Ye Guo, Yaling Dou, Jun Lin
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    Se Lim Kim, Min Woo Shin, Seung Young Seo, Sang Wook Kim
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    Su Hyun Park, Sang Hyoung Park
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    Chenglin Ye, Sizhe Zhu, Yuan Gao, Yabing Huang
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    M. Hornschuh, E. Wirthgen, M. Wolfien, K. P. Singh, O. Wolkenhauer, J. Däbritz
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  • SFRP5 inhibits melanin synthesis of melanocytes in vitiligo by suppressing the Wnt/β-catenin signaling
    Dao-Pei Zou, Yang-Mei Chen, Ling-Zhao Zhang, Xiao-Hui Yuan, Yu-Jie Zhang, Adelina Inggawati, Pham Thi Kieu Nguyet, Tian-Wen Gao, Jin Chen
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Inflammatory bowel diseases
Presentation and outcomes among inflammatory bowel disease patients with concurrent pneumatosis intestinalis: a case series and systematic review
Youran Gao, Meka Uffenheimer, Michael Ashamallah, Gregory Grimaldi, Arun Swaminath, Keith Sultan
Intest Res 2020;18(3):289-296.   Published online November 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00073
AbstractAbstract PDFPubReaderePub
Background/Aims
Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn’s disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined.
Methods
We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes for IBD. CT and chart review was performed to confirm PI and IBD respectively. A systematic review excluding case reports was performed for PI with IBD for comparison.
Results
Of 5,990 patients with a CT abdomen report mentioning PI, we identified 11 cases of PI with IBD, 4 UC, 6 CD, and 1 indeterminate colitis. PI was limited to the small bowel in 5 patients, the right colon in 5, and small bowel and colonic in 1. All 3 mortalities had CD, small intestinal PI and portal/mesenteric venous gas. The systematic literature search identified 9 articles describing 58 patients with IBD and PI. These cases were mostly included in larger cohorts of PI patients without extractable data on presentation or outcomes in the IBD subpopulation.
Conclusions
Ours appears to be the first reporting of presentations and outcomes, outside of case reports, for those with PI and IBD. The high mortality for those with CD and PI of the small bowel appears to define a group requiring more than supportive medical care.

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    Julia Song, Biqi Zhang, David Mahvi, Mahsa Shariat, Manuel Castillo-Angeles, Tanujit Dey, Reza Askari
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    Amir Reza Radmard, Mehrnam Amouei, Ala Torabi, Ali Reza Sima, Hiva Saffar, Amine Geahchan, Amir H. Davarpanah, Bachir Taouli
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    Atsushi Ikehata, Machi Kiyohara, Sadahide Ono, Takashi Kajiwara
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    Gennaro Perrone, Mario Giuffrida, Valentina Donato, Gabriele Luciano Petracca, Giorgio Rossi, Giacomo Franzini, Sara Cecconi, Alfredo Annicchiarico, Elena Bonati, Fausto Catena
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    Charles Vallejo, Yousra Gheit, Talwinder K Nagi, Zoilo K Suarez, Muhammad Haider, Touqir Zahra
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    Giuseppe Tropeano, Marta Di Grezia, Caterina Puccioni, Valentina Bianchi, Gilda Pepe, Valeria Fico, Gaia Altieri, Giuseppe Brisinda
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    David Charry-Borrero, Yesica Ascanio-Quintero, Juan Rodríguez-Valenzuela, Faure Yezid Rodríguez-Velásquez, Juan Felipe Coronado-Sarmiento, Eduardo Tuta-Quintero
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    Gitte Grunnet Raabe, Benedicte Schelde-Olesen, Thomas Bjørsum-Meyer
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    Gianluca Gazzaniga, Federica Villa, Federica Tosi, Elio Gregory Pizzutilo, Stefano Colla, Stefano D’Onghia, Giusy Di Sanza, Giulia Fornasier, Michele Gringeri, Maria Victoria Lucatelli, Giulia Mosini, Arianna Pani, Salvatore Siena, Francesco Scaglione, An
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    Blake J. McKinley, Mariangela Santiago, Christi Pak, Nataly Nguyen, Qing Zhong
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Inflammatory bowel diseases
Safety of tumor necrosis factor inhibitor use in patients with concomitant malignancy
Hiep Phan, Rick A. Weideman, Daisha J. Cipher, Linda A. Feagins
Intest Res 2020;18(3):282-288.   Published online April 7, 2020
DOI: https://doi.org/10.5217/ir.2019.09140
AbstractAbstract PDFPubReaderePub
Background/Aims
Safety for tumor necrosis factor inhibitors (TNFi) in cancer has been focused on risk of incident malignancies, but studies on prognostic effects have been scarce. We determined survival and recurrence rates at 1, 2, and 5 years after cancer diagnosis in patients with and without concurrent TNFi use.
Methods
Chart reviews were performed between 1996 and 2015 at the VA North Texas Healthcare System. Cases were patients with inflammatory disease, concomitant malignancy, and TNFi use while controls were patients with inflammatory disease, concomitant malignancy but no TNFi use. Cases and controls were matched for type of malignancy. Analysis was performed with log-rank tests on Kaplan-Meier curves.
Results
Thirty-six cases and 72 controls were identified. For cases, survival at 1, 2, and 5 years were 32 (89%), 31 (86%), and 29 (81%) compared to 63 (90%), 61 (87%), and 51 (73%) for the control group (P=0.985). For cases, recurrence rates at 1, 2, and 5 years were 3 (8%), 5 (14%), and 6 (17%) compared to 2 (3%), 5 (7%), and 7 (10%) for the control group (P=0.158).
Conclusions
Our findings suggest TNFi may be safely used in select inflammatory disease patients with concurrent cancer if therapy is needed for proper disease control. However, case-by-case consideration in conjunction with an oncologist is recommended while considering the apparent safety of TNFi for patients suffering from active inflammatory diseases despite having a concomitant malignancy.

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    Oh Chan Kwon, Hye Sun Lee, So Young Jeon, Min-Chan Park
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    Akshita Gupta, Laurent Peyrin-Biroulet, Ashwin N. Ananthakrishnan
    Clinical Gastroenterology and Hepatology.2024; 22(3): 499.     CrossRef
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    Juan I. Ruiz, Xiudong Lei, Wu Chi-Fang, Sharon H. Giordano, Hui Zhao, Suja S. Rajan, Heather Lin, Maria E. Suarez-Almazor
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    Takeshi Takasago, Ryohei Hayashi, Yoshitaka Ueno, Misa Ariyoshi, Kana Onishi, Ken Yamashita, Yuichi Hiyama, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka, Yasuhiko Kitadai, Shinji Tanaka, Kenji Fujiwara
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    Ivo Klarin, Yoshihiro Moriwaki
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    Young Bin Joo, Seung Min Jung, Yune-Jung Park, Ki-Jo Kim, Kyung-Su Park
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  • Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
    Jihye Park, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2022; 37(5): 895.     CrossRef
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    Julia Berman, Yarden Yavne, Yonatan Edel, Ori Elkayam, Victoria Furer, Daniel Shepshelovich
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    Namrata Singh, Christopher I. Li
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    Jihye Park, Jae Hee Cheon
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Miscellaneous
Clinical profile and outcomes of opioid abuse gastroenteropathy: an underdiagnosed disease entity
Ramit Mahajan, Yogesh Gupta, Arshdeep Singh, Pulkit Dhiman, Vandana Midha, Chandan Kakkar, Vikram Narang, Varun Mehta, Kavita Saggar, Ajit Sood
Intest Res 2020;18(2):238-244.   Published online February 25, 2020
DOI: https://doi.org/10.5217/ir.2019.00104
AbstractAbstract PDFPubReaderePub
Background/Aims
Opioid-induced bowel dysfunction includes nausea, vomiting, constipation and abdominal distension. We describe patients presenting with gastrointestinal (GI) ulcers and ulcerated strictures secondary to opioid abuse, an entity not well described in literature.
Methods
This retrospective observational study included patients with opioid abuse gastroenteropathy presenting to Dayanand Medical College and Hospital, Ludhiana, India between January 2013 and December 2018. Opioid abuse gastroenteropathy was defined as gastric or small bowel ulcers and ulcerated strictures in patients abusing opioids, where all other possible etiologies of GI ulcers/strictures were excluded. Clinical, biochemical, endoscopic, radiological and histological parameters as well as response to treatment were assessed.
Results
During the study period, 20 patients (mean age, 38.5±14.2 years; 100% males) were diagnosed to have opioid induced GI ulcers and/or ulcerated strictures. The mean duration of opioid consumption was 6.2±3.4 years. The mean duration of symptoms at presentation was 222.1±392.3 days. Thirteen patients (65%) had gastroduodenal involvement, 6 (30%) had a jejunoileal disease and 1 (5%) had an ileocecal stricture. Two patients (10%) presented with upper GI bleeding, 11 (55%) had features of gastric outlet obstruction and 7 (35%) presented with small bowel obstruction. Abdominal pain and iron deficiency anemia were the most common presentations. Only 1 patient (5%) responded to proton pump inhibitors, 3 (15%) had a lasting response to endoscopic balloon dilatation, while all other (80%) required surgical intervention.
Conclusions
Opioid abuse gastroenteropathy presents as ulcers and ulcerated strictures which respond poorly to medical management and endoscopic balloon dilatation. A majority of these cases need surgical intervention.

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Endoscopy
Prototype single-balloon enteroscopy with passive bending and high force transmission improves depth of insertion in the small intestine
Yasuhiro Morita, Shigeki Bamba, Osamu Inatomi, Kenichiro Takahashi, Takayuki Imai, Masaki Murata, Masashi Ohno, Masaya Sasaki, Tomoyuki Tsujikawa, Akira Andoh
Intest Res 2020;18(2):229-237.   Published online April 9, 2020
DOI: https://doi.org/10.5217/ir.2019.09150
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We retrospectively analyzed Crohn’s disease (CD) patients with small intestinal strictures who underwent single-balloon enteroscopy (SBE) to ascertain whether prototype SBEs with a passive bending mechanism and high force transmission insertion tube had better insertability in the small intestine than a conventional SBE.
Methods
Among 253 CD patients who underwent SBE, we identified 94 CD patients who had undergone attempted endoscopic balloon dilatation (EBD) for small intestinal stenosis for inclusion in this study. We analyzed whether the type of scope used for their initial procedure affected the cumulative surgery-free rate. For the insertability analysis, patients who underwent SBE at least twice were divided into 3 groups according to the type of scope used: conventional SBE only, prototype SBE only, and both conventional and prototype SBEs. For each group, depth of insertion, procedure time, and number of EBDs were compared in the same patient at different time points.
Results
The success rate of EBD was 88.3%. The 5- and 10-year cumulative surgery-free rate was 75.7% and 72.8%, respectively. Cox regression analysis indicated that the factors contributing to surgery were long stricture (≥2 cm), EBD failure, and elevated Crohn’s Disease Activity Index, but not the type of scope used for EBD. The prototype SBEs significantly improved the depth of insertion (P=0.03, Wilcoxon’s signed-rank test).
Conclusions
In CD patients with small intestinal stenosis, the prototype SBEs with a passive bending mechanism and high force transmission insertion tube did not improve long-term EBD outcome but did improve deep insertability. (Clinical Trial Registration No. UMIN000037102)

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  • Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
    Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
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    Yuna Kim, Jae-Hyun Kim, Eun-Ae Kang, Soo-Jung Park, Jae-Jun Park, Jae-Hee Cheon, Tae-Il Kim, Jihye Park, Seong-Ran Jeon
    Diagnostics.2022; 12(4): 954.     CrossRef
  • Intestinal stricture in Crohn's disease: A 2020 update
    Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
    Journal of Digestive Diseases.2021; 22(7): 390.     CrossRef
  • Factors Affecting Route Selection of Balloon-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
    Dong Hoon Baek, Seonyeong Hwang, Chang Soo Eun, Seong Ran Jeon, Jinsu Kim, Eun Ran Kim, Dong-Hoon Yang, Hyun Joo Jang, Jong Pil Im, Soo Jung Park, Sung Hoon Jung
    Diagnostics.2021; 11(10): 1860.     CrossRef
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Inflammatory bowel diseases
Inhibition of plasminogen activator inhibitor-1 attenuates against intestinal fibrosis in mice
Jin Imai, Takashi Yahata, Hitoshi Ichikawa, Abd Aziz Ibrahim, Masaki Yazawa, Hideaki Sumiyoshi, Yutaka Inagaki, Masashi Matsushima, Takayoshi Suzuki, Tetsuya Mine, Kiyoshi Ando, Toshio Miyata, Katsuto Hozumi
Intest Res 2020;18(2):219-228.   Published online February 17, 2020
DOI: https://doi.org/10.5217/ir.2019.00037
AbstractAbstract PDFPubReaderePub
Background/Aims
Intestinal fibrosis is a major complication of Crohn’s disease (CD). The profibrotic protein transforming growth factor-β (TGF-β) has been considered to be critical for the induction of the fibrotic program. TGF-β has the ability to induce not only the expression of extracellular matrix (ECM) including collagen, but also the production of plasminogen activator inhibitor-1 (PAI-1) that prevents enzymatic degradation of the ECM during the onset of fibrotic diseases. However, the significance of PAI-1 in the developing intestinal fibrosis has not been fully understood. In the present study, we examined the actual expression of PAI-1 in fibrotic legion of intestinal inflammation and its correlation with the abnormal ECM deposition.
Methods
Chronic intestinal inflammation was induced in BALB/c mice using 8 repeated intrarectal injections of 2,4,6-trinitrobenzene sulfonic acid (TNBS). TM5275, a PAI-1 inhibitor, was orally administered as a carboxymethyl cellulose suspension each day for 2 weeks after the sixth TNBS injection.
Results
Using a publicly available dataset (accession number, GSE75214) and TNBS-treated mice, we observed increases in PAI-1 transcripts at active fibrotic lesions in both patients with CD and mice with chronic intestinal inflammation. Oral administration of TM5275 immediately after the onset of intestinal fibrosis upregulated MMP-9 (matrix metalloproteinase 9) and decreased collagen accumulation, resulting in attenuation of the fibrogenesis in TNBS-treated mice.
Conclusions
PAI-1-mediated fibrinolytic system facilitates collagen degradation suppression. Hence, PAI-1 inhibitor could be applied as an anti-fibrotic drug in CD treatment.

Citations

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  • Novel Transcriptomic Signatures in Fibrostenotic Crohn’s Disease: Dysregulated Pathways, Promising Biomarkers, and Putative Therapeutic Targets
    Animesh Acharjee, Uday Shivaji, Giovanni Santacroce, Sarah Akiror, Louisa Jeffery, Csilla Varnai, Gary Reynolds, Davide Zardo, Snehali Majumder, Asma Amamou, Georgios V Gkoutos, Marietta Iacucci, Subrata Ghosh
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    Yuling Wang, Linke Jiao, Caoxia Qiang, Chen Chen, Zihuan Shen, Fan Ding, Lifei Lv, Tingting Zhu, Yingdong Lu, Xiangning Cui
    Biomedicine & Pharmacotherapy.2024; 171: 116116.     CrossRef
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    Abd Aziz Ibrahim, Taku Fujimura, Tomoko Uno, Tomoya Terada, Ken-ichi Hirano, Hiroyuki Hosokawa, Akio Ohta, Toshio Miyata, Kiyoshi Ando, Takashi Yahata
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Fibrostenosing Crohn’s Disease: Pathogenetic Mechanisms and New Therapeutic Horizons
    Irene Mignini, Valentina Blasi, Fabrizio Termite, Giorgio Esposto, Raffaele Borriello, Lucrezia Laterza, Franco Scaldaferri, Maria Elena Ainora, Antonio Gasbarrini, Maria Assunta Zocco
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  • Impact of Plasminogen Activator Inhibitor-1 Serum Levels and the -675 4G/5G Variant in the SERPINE1 Gene on Systemic Sclerosis in a Mexican Population
    José Alvaro Lomelí-Nieto, José Francisco Muñoz-Valle, José Eduardo Navarro-Zarza, Christian Johana Baños-Hernández, Jesús Alberto Gutierrez-Brito, Valeria Renteria-Cabrera, Eduardo Arturo Horta-Chávez, José Javier Morales-Núñez, Samuel García-Arellano, Is
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  • PAI-1 siRNA-loaded biomimetic nanoparticles for ameliorating diminished ovarian reserve and inhibiting ovarian fibrosis
    Hua Guo, Chang Xiao, Xinshu Li, Jialing Li, Xue Chen, Bin liu, Rong Hu
    European Journal of Pharmacology.2024; : 176948.     CrossRef
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    Guanhao Hong, Yulan Zhou, Shukai Yang, Shouquan Yan, Jiaxu Lu, Bo Xu, Zeyu Zhan, Huasheng Jiang, Bo Wei, Jiafeng Wang
    Stem Cells.2024; 42(12): 1055.     CrossRef
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    Aya A. Touny, Balaji Venkataraman, Shreesh Ojha, Mauro Pessia, Veedamali S. Subramanian, Shamanth Neralagundi Hariharagowdru, Sandeep B. Subramanya
    Nutrients.2024; 16(21): 3633.     CrossRef
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    Virginia Solitano, Arianna Dal Buono, Roberto Gabbiadini, Marek Wozny, Alessandro Repici, Antonino Spinelli, Stefania Vetrano, Alessandro Armuzzi
    Journal of Clinical Medicine.2023; 12(9): 3052.     CrossRef
  • Downregulation of Heat Shock Protein 72 Contributes to Fibrostenosis in Crohn’s Disease
    Seung Won Kim, Jae-Young Lee, Han Cheol Lee, Jae Bum Ahn, Ji Hyung Kim, I Seul Park, Jae Hee Cheon, Duk Hwan Kim
    Gut and Liver.2023; 17(6): 905.     CrossRef
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    Silvia D’Alessio, Federica Ungaro, Daniele Noviello, Sara Lovisa, Laurent Peyrin-Biroulet, Silvio Danese
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    Yuki Hayashi, Hiroshi Nakase
    Frontiers in Physiology.2022;[Epub]     CrossRef
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    Taylor J. Louis, Ahmad Qasem, Saleh A. Naser
    Frontiers in Immunology.2022;[Epub]     CrossRef
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    Ilaria Laudadio, Alex Bastianelli, Valerio Fulci, Claudia Carissimi, Eleonora Colantoni, Francesca Palone, Roberta Vitali, Elisa Lorefice, Salvatore Cucchiara, Anna Negroni, Laura Stronati
    International Journal of Molecular Sciences.2022; 23(18): 10261.     CrossRef
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    Hui Yao, Guoyao Tang
    Cellular Immunology.2022; 381: 104614.     CrossRef
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    Joseph Sleiman, Sara El Ouali, Taha Qazi, Benjamin Cohen, Scott R. Steele, Mark E. Baker, Florian Rieder
    Expert Review of Gastroenterology & Hepatology.2021; 15(4): 401.     CrossRef
  • Elevated expression of plasminogen activator inhibitor (PAI-1/SERPINE1) is independent from rs1799889 genotypes in arthrofibrosis
    Banu Bayram, Aaron R. Owen, Amel Dudakovic, Jacob W. Bettencourt, Afton K. Limberg, Mark E. Morrey, Joaquin Sanchez-Sotelo, Daniel J. Berry, Jean-Pierre A. Kocher, Andre J. van Wijnen, Matthew P. Abdel
    Meta Gene.2021; 28: 100877.     CrossRef
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    Muaad Abdulla, Thean Soon Chew
    Current Opinion in Gastroenterology.2021; 37(3): 275.     CrossRef
  • Intestinal stricture in Crohn's disease: A 2020 update
    Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
    Journal of Digestive Diseases.2021; 22(7): 390.     CrossRef
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    Takashi Yahata
    Japanese Journal of Thrombosis and Hemostasis.2020; 31(3): 310.     CrossRef
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Inflammatory bowel diseases
Histologically confirmed upper gastrointestinal Crohn’s disease: is it rare or are we just not searching hard enough?
Omar Ibrahim Saadah, Kholoud Bakur Fallatah, Cedric Baumann, Abdulrahman Ahmed Elbaradie, Fatimah Talat Howladar, Motaz Tariq Daiwali, Omar Hamad Alshuaibi, Majid Abdulaziz Alsahafi, Rana Yaqoob Bokhary, Yousef Abdulfattah Qari, Laurent Peyrin-Biroulet, Mahmoud Hisham Mosli
Intest Res 2020;18(2):210-218.   Published online February 7, 2020
DOI: https://doi.org/10.5217/ir.2019.00091
AbstractAbstract PDFPubReaderePub
Background/Aims
Crohn’s disease (CD) may involve the upper parts of the gastrointestinal (GI) tract including the esophagus, stomach, and duodenum. Clinical features of upper GI CD (UGICD) are not well characterized in the Gulf region. We therefore aimed to assess the prevalence and clinical characteristics of patients diagnosed with UGICD.
Methods
We performed a retrospective analysis of all patients diagnosed with CD who underwent upper GI endoscopy between 2012 and 2017 at King Abdulaziz University Hospital, irrespective of age. Patients who had endoscopy of the upper GI tract at baseline and had histologically confirmed UGICD were included. Data on patients’ demographics, clinical characteristics, extraintestinal manifestations and complications were reviewed.
Results
We identified 78 CD patients who underwent upper GI endoscopy from our medical records. The mean age was 17.2±8.7 years and 55.1% were males. Of the total, 19 out of 78 patients (24.4%) had histologically confirmed UGICD (3 esophageal, 16 gastric, and 9 duodenal), of which 52.6% were symptomatic. Disease distribution was ileal in 57.8%, colonic in 21.1% and ileo-colonic in 21.1%. A non-stricturing and non-penetrating phenotype was reported in 89.4%, stricturing in 5.3%, and penetrating in 5.3%. Perianal disease was found in 10.5%. UGICD was complicated by stricture formation in 2 patients (esophageal and gastric).
Conclusions
The prevalence of UGICD is considered high among CD Saudi patients who undergo upper GI endoscopy at baseline, and is asymptomatic in 47.4% of patients. This reported prevalence is not dissimilar from reports originating from Western countries.

Citations

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    Badr AbdullGaffar, Huda Quarishi
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    Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
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    Mahmoud H. Mosli, Hajer Y. Almudaiheem, Turki AlAmeel, Shakir A. Bakkari, Othman R. Alharbi, Khalidah A. Alenzi, Amr M. Khardaly, Maha A. AlMolaiki, Bedor A. Al-Omari, Rayan G. Albarakati, Ahmed H. Al-Jedai, Omar I. Saadah, Majid A. Almadi, Badr Al-Baward
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    Naoimh Herlihy, Roger Feakins
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    Badr AbdullGaffar, Hoda Quraishi
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    Badr AbdullGaffar, Hoda Quraishi
    International Journal of Surgical Pathology.2021; 29(8): 926.     CrossRef
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    Yip Han Chin, Cheng Han Ng, Snow Yunni Lin, Sneha Rajiv Jain, Gwyneth Kong, Jeffery Wei Heng Koh, Darren Jun Hao Tan, David Eng Hui Ong, Mark Dhinesh Muthiah, Choon Seng Chong, Fung Joon Foo, Rupert Leong, Webber Pak Wo Chan
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    Luca Mastracci, Federica Grillo, Paola Parente, Elettra Unti, Serena Battista, Paola Spaggiari, Michela Campora, Luca Valle, Matteo Fassan, Roberto Fiocca
    Pathologica.2020; 112(3): 128.     CrossRef
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Inflammatory bowel diseases
Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease
Yue Zhao, Baili Chen, Yao He, Shenghong Zhang, Yun Qiu, Rui Feng, Hongsheng Yang, Zhirong Zeng, Shomron Ben-Horin, Minhu Chen, Ren Mao
Intest Res 2020;18(2):200-209.   Published online March 31, 2020
DOI: https://doi.org/10.5217/ir.2019.00103
AbstractAbstract PDFPubReaderePub
Background/Aims
Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD.
Methods
This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay.
Results
The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients.
Conclusions
Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Citations

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    Anneliese Long, Anne Z. Steiner, Amanda L. Thompson, Hannah R. Jahnke, Benjamin S. Harris, Anne Marie Jukic
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    Maria Martell, Clare F. Quarnstrom, Alexander Khoruts, Vaiva Vezys, Christopher Staley, Eugenia Shmidt
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    Matteo Bramuzzo, Fabiola Giudici, Serena Arrigo, Paolo Lionetti, Giovanna Zuin, Claudio Romano, Francesco Graziano, Simona Faraci, Patrizia Alvisi, Sara Signa, Luca Scarallo, Stefano Martelossi, Grazia Di Leo
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    Ana Gutiérrez, Roser Muñoz-Pérez, Pedro Zapater, Cristina Mira, Andrés Rodríguez, Laura Sempere-Robles, María Eugenia Torregrosa, Rocio Alfayate, Violeta Moreno-Torres, Lorena Bernal, Olivia Belén-Galipienso, Jose Ignacio Cameo, Paula Sirera, Belen Herrer
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    Arthur Foulon, Nicolas Richard, Camille Guichard, Clara Yzet, Coraline Breuval, Jean Gondry, Rosalie Cabry‐Goubet, Audrey Michaud, Mathurin Fumery
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    Ailifeire Tuerxuntayi, Tian Shi, Beiyao Gao, Yan Feng, Ting Li, Wenjia Hui, Shenglong Xue, Feng Gao
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    Paola De Nardi, Greta Giacomel, Simone Orlandi, Giulia Poli, Mauro Pozzo, Marcella Rinaldi, Antonella Veglia, Renato Pietroletti
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    Xu-Jie Dai, Zhen Guo
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    Max N. Brondfield, Uma Mahadevan
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    Peng Guo, Wulan Cao
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    Eugenia Shmidt, Marla C. Dubinsky
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    Sanket Patel, Haleh Vaziri
    Current Treatment Options in Gastroenterology.2021; 19(2): 237.     CrossRef
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    T. Koller, J. Kollerová, T. Hlavatý, B. Kadlečková, J. Payer
    Physiological Research.2021; : S69.     CrossRef
  • THE ROLE OF IMMUNOGLOBULIN A IN THE INFLAMMATORY PROCESS INVOLVING NEUTROPHILS
    O.O. Prudnikov, I.M. Prudnikov, V.M. Tsyvkin, A.M. Smirnov, R.I. Yanchiy
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    Rachel W. Winter, Sonia Friedman
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  • 133 Download
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Inflammatory bowel diseases
Changes in prevalence and perception of complementary and alternative medicine use in Korean inflammatory bowel disease patients: results of an 8-year follow-up survey
Sun-Ho Lee, Kiju Chang, Ki Seok Seo, Yun Kyung Cho, Eun Mi Song, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Intest Res 2020;18(2):192-199.   Published online April 3, 2020
DOI: https://doi.org/10.5217/ir.2019.00115
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The use of complementary and alternative medicine (CAM) is a global phenomenon, including inflammatory bowel disease (IBD) patients. We aimed to assess the change in prevalence and patterns of CAM use, and attitudes towards CAM over an 8-year time interval (2006 vs. 2014) among IBD patients in Korea.
Methods
A total of 221 IBD patients (CD=142, UC=79) were asked to complete a questionnaire regarding CAM at two time points: at enrollment (2006) and 8 years later (2014/2015).
Results
The proportion of patients ever using CAM increased significantly from 60.2% in 2006 to 79.6% in 2014 (P<0.001), while the proportion of current CAM users increased slightly (35.7% to 38.0%, P=0.635); 21.7% used CAM consistently at both time points. The proportion of patients who felt CAM was less effective (P<0.001) and more expensive (P=0.04) than conventional treatments increased over time. Also, the proportion among ever CAM users who perceived a positive effect from CAM significantly decreased in 2014 compared to 2006 (P=0.004). Higher education (adjusted odds ratio [aOR], 2.10), prior side effects to conventional therapies (aOR, 2.23), and prior use of corticosteroids (aOR, 2.51) were associated with CAM use. Interestingly, use of CAM before IBD diagnosis (aOR, 2.73) was significantly associated with consistent CAM use.
Conclusions
Although the attitudes toward CAM have become less favorable, the majority of IBD patients have experienced CAM with an overall increase of current CAM users over time. Moreover, more than half of current CAM users used CAM consistently over time.

Citations

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  • Effects of self-acupressure on quality of life and abdominal pain severity among patients with inflammatory bowel disease: A randomized sham-controlled trial
    Nahid Rajai, Zahra Abbasi, Amir Hosein Pishgooie, Fatemeh Teymouri, Mohammad Imanipour
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    Eun Soo Kim, Chung Hyun Tae, Sung-Ae Jung, Dong Il Park, Jong Pil Im, Chang Soo Eun, Hyuk Yoon, Byung Ik Jang, Haruhiko Ogata, Kayoko Fukuhara, Fumihito Hirai, Kazuo Ohtsuka, Jing Liu, Qian Cao
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    Jae Song Kim, Min Jung Geum, Eun Sun Son, Yun Mi Yu, Jae Hee Cheon, Kyeng Hee Kwon
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    Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
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    Jae Myung Cha
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  • 123 Download
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  • 7 Crossref
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Inflammatory bowel diseases
Exclusive enteral nutrition for induction of remission in anti-tumor necrosis factor refractory adult Crohn’s disease: the Indian experience
Ajit Sood, Arshdeep Singh, Ritu Sudhakar, Vandana Midha, Ramit Mahajan, Varun Mehta, Yogesh Kumar Gupta, Kirandeep Kaur
Intest Res 2020;18(2):184-191.   Published online February 25, 2020
DOI: https://doi.org/10.5217/ir.2019.00094
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Exclusive enteral nutrition (EEN) is recommended for induction of remission in pediatric Crohn’s disease (CD). However, it is not currently recommended for inducing remission in adults. This report describes the use of 12-week EEN for induction of remission in anti-tumor necrosis factor (anti-TNF) refractory adult CD.
Methods
This is a retrospective analysis of adults with moderate to severe active (Crohn’s Disease Activity Index [CDAI] >220) anti-TNF refractory CD, who received EEN for 12 weeks between April 2018 and March 2019 at Dayanand Medical College and Hospital, Ludhiana, India. Primary outcomes included achievement of clinical remission and fistula healing at 12 weeks. Improvement in inflammatory markers and nutritional status were the secondary end points.
Results
Out of 23 patients who received anti-TNF agents, 7 (30.4%) were refractory and were offered EEN as a salvage therapy. Six patients (66.7% females, mean age 25.6±6.5 years) consented. Four patients (66.6%) achieved clinical remission (CDAI <150). Mean CDAI of patients decreased significantly after 12 weeks of EEN (388.8±74.8 vs. 160.0±25.2, P<0.001). Perianal fistulas showed clinical response (drainage decreased by >50%), though none achieved remission. Entero-enteric fistulae showed complete healing. Mean body mass index improved from 15.6±3.1 to 18.9±1.9 kg/m2 at week 12 (P=0.003). Hemoglobin and serum albumin also improved from 8.2±1.1 g/dL and 2.8±0.3 g/dL at baseline to 12.6±0.6 g/dL and 3.6±0.5 g/dL post-EEN respectively (P<0.001 and P=0.006 respectively).
Conclusions
EEN appears to be an effective and well tolerated therapy for induction of remission in anti-TNF refractory adult CD. More data from prospective trials with larger number of patients is required.

Citations

Citations to this article as recorded by  
  • Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
    Hellen Kuo, Katrina Tognolini, Rumbidzai Mutsekwa, Dheeraj Shukla, Laura Willmann, Hadi Moattar, Alexander Dorrington, Naveed Ishaq, Maneesha Bhullar, John Edwards, Waled Mohsen, Pradeep Kakkadasam Ramaswamy
    Frontline Gastroenterology.2025; 16(1): 3.     CrossRef
  • Enteral Nutrition in Crohn’s Disease: A Comprehensive Review of Its Role in Induction and Maintenance of Remission and Perioperative Management in Adult Patients
    André Bargas, Carolina Palmela, Luisa Glória
    Nutrients.2025; 17(9): 1481.     CrossRef
  • Management of Perianal Fistulizing Crohn’s Disease
    Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
    Inflammatory Bowel Diseases.2024; 30(9): 1579.     CrossRef
  • Pharmacogenetics in personalized treatment in pediatric patients with inflammatory bowel disease (IBD)
    Daniela Kosorínová, Pavlína Suchá, Zuzana Havlíčeková, Marek Pršo, Pavol Dvoran, Peter Bánovčin
    Česko-slovenská pediatrie.2024; 79(4): 213.     CrossRef
  • Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn’s disease: A cohort study from northern India
    Arshdeep Singh, Chandan Kakkar, Shreya Garg, Kirti Arora, Vandana Midha, Ramit Mahajan, Satpal Singh Virk, Narender Pal Jain, Dharmatma Singh, Kriti Sood, Ashish Tripathi, Dhruv Gupta, Ishita Gupta Kaushal, Ritu Dhawan Galhotra, Kavita Saggar, Ajit Sood
    Indian Journal of Gastroenterology.2023; 42(5): 668.     CrossRef
  • Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease
    Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
    Nutrition in Clinical Practice.2023; 38(6): 1282.     CrossRef
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    Jihye Park, Jae Hee Cheon
    Yonsei Medical Journal.2021; 62(2): 99.     CrossRef
  • Review of exclusive enteral therapy in adult Crohn’s disease
    Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam
    BMJ Open Gastroenterology.2021; 8(1): e000745.     CrossRef
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    Ji Young Chang, Jae Hee Cheon
    Precision and Future Medicine.2021; 5(4): 151.     CrossRef
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    Tadakazu Hisamatsu
    Intestinal Research.2020; 18(2): 139.     CrossRef
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Miscellaneous
Vegetarianism as a protective factor for asymptomatic colonic diverticulosis in Asians: a retrospective cross-sectional and case-control study
Jihun Bong, Hyoun Woo Kang, Hyeki Cho, Ji Hyung Nam, Dong Kee Jang, Jae Hak Kim, Jun Kyu Lee, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee
Intest Res 2020;18(1):121-129.   Published online November 1, 2019
DOI: https://doi.org/10.5217/ir.2019.00106
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Dietary fiber intake is considered a protective factor for diverticular disease such as diverticulitis. However, evidence for an inverse connection between dietary fiber consumption and asymptomatic colonic diverticulosis is lacking. Specifically, few studies have investigated this subject in Asians with different presentations of diverticulosis. Therefore, we assessed the protective effects of a vegetarian diet for asymptomatic colonic diverticulosis in Buddhist monks who are obligatory vegetarians for spiritual reasons compared with the general population.
Methods
A retrospective, cross-sectional, case-control study was conducted in age- and sex-matched Buddhist monks and the general population who underwent colonoscopy for screening at a Korean health promotion center from August 2005 to June 2018. We compared the prevalence of asymptomatic diverticulosis between the 2 groups using a self-administered questionnaire.
Results
In this study, a total of 1,316 individuals were included (Buddhist monks of 658 and general population of 658) with a mean age of 52.6±9.5 years. The prevalence of asymptomatic diverticulosis in Buddhist monks was lower compared with the general population (6.7% [44/658] vs. 10.8% [71/658], P=0.008). Buddhist monks had a higher rate of high body mass index (BMI) and metabolic syndrome. By a multivariate regression analysis model, a nonvegetarian diet (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.21–2.72, P=0.004), old age (OR, 4.53; 95% CI, 1.36–15.12; P=0.014), male sex (OR, 1.91; 95% CI, 1.28–2.85; P=0.002), and a high BMI (OR, 1.50; 95% CI, 1.01–2.23; P=0.047) were independent predictors of asymptomatic diverticulosis. Moreover, a nonvegetarian diet was associated with both right-sided and left-sided diverticulosis.
Conclusions
A nonvegetarian diet may increase a risk of asymptomatic colonic diverticulosis in Asians.

Citations

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  • Association of Metabolic Syndrome Components and Colonic Diverticulosis in the Very Elderly: A Tertiary Health Network Study
    Hammad Liaquat, Farah Harmouch, Nishit Patel, Zarian Prenatt, Jill Stoltzfus, Berhanu Geme, Noel Martins, Kimberly Chaput
    Cureus.2024;[Epub]     CrossRef
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    Yehyun Park
    Intestinal Research.2023; 21(4): 415.     CrossRef
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    Ye Yan, Jian-Sheng Wu, Shuang Pan
    World Journal of Clinical Cases.2022; 10(1): 136.     CrossRef
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    You Sun Kim
    The Korean Journal of Gastroenterology.2022; 79(6): 233.     CrossRef
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    Greg A. Turner, Michael J. O'Grady, Sajith C. Senadeera, Chris J. Wakeman, Andrew McCombie, Rachel V. Purcell, Frank A. Frizelle
    ANZ Journal of Surgery.2021; 91(10): 2110.     CrossRef
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    Greg A. Turner, Michael J. O’Grady, Rachel V. Purcell, Frank A. Frizelle
    Annals of Coloproctology.2021; 37(4): 196.     CrossRef
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Functional bowel disorder
Proinflammatory cytokines in irritable bowel syndrome: a comparison with inflammatory bowel disease
Antigony Mitselou, Vasileios Grammeniatis, Anna Varouktsi, Stamatis S Papadatos, Konstantinos Katsanos, Vasiliki Galani
Intest Res 2020;18(1):115-120.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00125
AbstractAbstract PDFPubReaderePub
Background/Aims
Irritable bowel syndrome (IBS) is a common disease often considered as a functional intestinal disorder. Inflammation in IBS is a quite intriguing theory. The aim of this study was to investigate tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 expression in inflammatory bowel disease (IBD) patients, IBS patients and normal controls.
Methods
IBS and IBD patients along with normal controls were recruited in the study. In all groups, 2 pinch biopsies were taken at each of 3 anatomical sites (terminal ileum, cecum, and rectum). IBS patients were also subcategorized according to the syndrome clinical manifestations. Two monoclonal antibodies (mAb), TNF-α mAb and IL-6 mAb, and one polyclonal antibody IL-1β mAb were applied for immunohistochemical analysis.
Results
In IBD patients intensity of TNF-α and IL-1β were lower than in IBS patients or controls, while IL-6 was significantly increased comparing to the aforementioned groups. In IBS patients TNF-α was increased comparing to IBD patients or controls, while IL-6 and IL-1β were similar to controls. In IBS subgroups, TNF-α was lower in diarrhea predominant IBS patients and higher constipation predominant IBS patients. Differences among IBS subgroups regarding IL-6 and IL-1β were nonsignificant.
Conclusions
IL-6 seems to be the most important proinflammatory cytokine in IBD patients, while TNF-α could play a more significant role in IBS pathogenesis.

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Colorectal neoplasia
Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms
Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto
Intest Res 2020;18(1):107-114.   Published online November 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00061
AbstractAbstract PDFPubReaderePub
Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

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    Zugang Yin, Chenhui Yao, Limin Zhang, Shaohua Qi
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    Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
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    Md. Ariful Islam, Labanya Talukder, Md. Firoj Al, Subrata K. Sarker, S. M. Muyeen, Prangon Das, Md. Mehedi Hasan, Sajal K. Das, Md. Manirul Islam, Md. Robiul Islam, Sumaya Ishrat Moyeen, Faisal R. Badal, Md. Hafiz Ahamed, Sarafat Hussain Abhi
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    Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
    Gut and Liver.2022; 16(5): 754.     CrossRef
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    Ji Young Chang
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    Heng Guo, Ying Li, Weizhi Qi, Lei Xi
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    Yu Zhang, Hui-Yan Chen, Xiao-Lu Zhou, Wen-Sheng Pan, Xin-Xin Zhou, Hang-Hai Pan
    World Journal of Gastroenterology.2020; 26(40): 6279.     CrossRef
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Colorectal neoplasia
Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery
Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Intest Res 2020;18(1):96-106.   Published online January 30, 2020
DOI: https://doi.org/10.5217/ir.2019.00092
AbstractAbstract PDFPubReaderePub
Background/Aims
We aimed to investigate the proportion of and risk factors for residual cancer and/or lymph node metastasis after surgery was performed because of high-risk pathological features in endoscopic resection specimen of suspected superficial submucosal colorectal cancer (SSMC).
Methods
We reviewed medical records of 497 patients (58.8 ± 9.8 years, 331 males) undergoing endoscopic resection of suspected SSMC. High-risk pathological features included: deep submucosal cancer invasion ≥ 1,000 μm; positive lymphovascular and/or perineural invasion; poorly differentiated adenocarcinoma; and positive resection margin. We investigated the occurrence of additional surgery and residual cancer and/or lymph node involvement in the surgical specimen.
Results
En bloc resection was performed in 447 patients (89.9%). High-risk pathological features were detected in 372 patients (74.8%). Additional surgery was performed in 336 of 372 patients with high-risk pathological features. Of these, 47 surgical specimens (14.0%) showed residual cancer and/or lymph node metastasis. Piecemeal resection was more common in those with residual cancer and/or lymph node involvement than those without (9/47 [19.1%] vs. 24/289 [8.3%], P= 0.032). Positive resection margin was also significantly associated with positive residual cancer and/or lymph node involvement. As the number of high-risk pathological features increased, the risk of regional lymph node metastasis increased proportionally (P= 0.002).
Conclusions
High-risk pathological features were frequently detected after endoscopic resection of suspected SSMC while residual cancer and/or lymph node metastasis were not commonly present in the additional surgical specimen. Further optimized strategy for proper endoscopic management of suspected SSMC is necessary.

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Inflammatory bowel diseases
Is fasting beneficial for hospitalized patients with inflammatory bowel diseases?
Yong Eun Park, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jung Nam Kim, Na Rae Lee, Jae Hee Cheon
Intest Res 2020;18(1):85-95.   Published online July 19, 2019
DOI: https://doi.org/10.5217/ir.2019.00055
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with inflammatory bowel disease (IBD) are usually hospitalized because of aggravated gastrointestinal symptoms. Many clinicians empirically advise these patients to fast once they are admitted. However, there has been no evidence that maintaining a complete bowel rest improves the disease course. Therefore, we aimed to investigate the effects of fasting on disease course in admitted patients with IBD or intestinal Behçet’s disease.
Methods
A total of 222 patients with IBD or intestinal Behçet’s disease, who were admitted for disease-related symptoms, were retrospectively analyzed. We divided them into 2 groups: fasting group (allowed to take sips of water but no food at the time of admission) and dietary group (received liquid, soft, or general diet).
Results
On admission, 124 patients (55.9%) started fasting and 98 patients (44.1%) started diet immediately. Among patients hospitalized through the emergency room, a significantly higher proportion underwent fasting (63.7% vs. 21.4%, P<0.001); however, 96.0% of the patients experienced dietary changes. Corticosteroid use (P<0.001; hazard ratio, 2.445; 95% confidence interval, 1.506–3.969) was significantly associated with a reduction in the disease activity score, although there was no significant difference between the fasting group and the dietary group in disease activity reduction (P=0.111) on multivariate analysis.
Conclusions
In terms of disease activity reduction, there was no significant difference between the fasting and dietary groups in admitted patients with IBD, suggesting that imprudent fasting is not helpful in improving the disease course. Therefore, peroral diet should not be avoided unless not tolerated by the patient.

Citations

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